Contrast-enhanced Magnetic Resonance Imaging in Patients With Dropped Head Syndrome.

Autor: Endo K; Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan., Nishimura H, Sawaji Y, Aihara T, Suzuki H, Konishi T, Nagayama K, Yamamoto K
Jazyk: angličtina
Zdroj: Spine [Spine (Phila Pa 1976)] 2024 Mar 15; Vol. 49 (6), pp. 385-389. Date of Electronic Publication: 2023 Oct 04.
DOI: 10.1097/BRS.0000000000004841
Abstrakt: Study Design: This is a retrospective study of a consecutive case series of dropped head syndrome (DHS).
Objective: To identify the characteristic features of contrast-enhanced magnetic resonance imaging (MRI) in DHS patients.
Summary of Background Data: Isolated neck extensor myopathy DHS is thought to be caused by severe cervical extensor muscle weakness from age-related loss of elasticity. However, the MRI findings of the cervical extensor muscles in DHS patients have not yet been characterized.
Materials and Methods: The subjects were 34 patients with isolated neck extensor myopathy DHS who underwent contrast-enhanced MRI within seven months after onset and 32 patients with age-matched cervical spondylosis or cervical soft-tissue tumor as controls. The presence of enhanced findings in the cervical extensor muscles, the involved cervical levels, and the characteristically enhanced shape of those muscles were evaluated using contrast-enhanced MRI.
Results: In the DHS group, the contrast-enhanced MRI showed pronounced enhancement at splenius capitis in 34 cases, rhomboid in 23 cases, semispinalis cervicis in seven cases, and levator scapulae in three cases. In the non-DHS group, none of those extensor muscles were enhanced. The enhanced pattern was butterfly shaped in 29 cases (85.3%) and linear in five cases (14.7%). All were located at the spinous process attachment at C6 or C7 in the DHS group. In the non-DHS group, seven cases presented an enhanced image of the spinous process, with C5-6 in one case, C6 in five cases, and C7 in one case.
Conclusions: In DHS, contrast-enhanced MRI showed intramuscular enhancement of the cervical extensor muscles, which was not present in non-DHS cases. The enhanced muscles included the splenius capitis muscle in all cases. These findings may be useful for developing a strategy for DHS treatment.
Competing Interests: The authors report no conflicts of interest.
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Databáze: MEDLINE