Dropped head syndrome after bilateral cervical radiofrequency ablation. A case report and literature review

Antonio Ojeda Niño , Oihane Manterola Lasa , Cesar Gracia Fabre , Carlos L. Nebreda-Clavo , Guilherme Ferreira-Dos-Santos , Rosario Armand-Ugon
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Abstract

Introduction

Cervical medial branch radiofrequency ablation is an effective treatment for cervical facet joint pain. It is considered a safe procedure, and permanent complications are very rare. We report a case of a patient who developed dropped-head syndrome (DHS) after bilateral treatment.

Case report

An 86-year-old man was referred to our pain clinic because of neck pain. One year before, he underwent bilateral multi-level cervical medial branch radiofrequency ablation. Within the next 24 hours, he experienced progressive neck extensor muscle weakness. After a comprehensive examination, he was diagnosed with dropped head syndrome as a complication of the radiofrequency procedure. Conservative management was chosen, resulting in partial improvement of the muscular weakness.

Conclusion

The present case, along with others reviewed in this article, supports the recommendation against performing bilateral and multilevel cervical medial branch radiofrequency ablation.

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双侧颈椎射频消融术后的低头综合征。病例报告和文献综述
引言 颈椎内侧支射频消融术是治疗颈椎面关节疼痛的有效方法。它被认为是一种安全的治疗方法,永久性并发症非常罕见。我们报告了一例在接受双侧治疗后出现垂头综合征(DHS)的患者。一年前,他接受了双侧多层次颈椎内侧支射频消融术。在接下来的 24 小时内,他出现了进行性颈部伸肌无力。经过全面检查,他被诊断为射频手术并发症--垂头综合征。结论:本病例和本文回顾的其他病例都支持不进行双侧和多级颈椎内侧支射频消融术的建议。
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Intraosseous basivertebral nerve ablation: A 5-year pooled analysis from three prospective clinical trials. Evaluating the effectiveness of interlaminar epidural steroid injections for cervical radiculopathy using PROMIS as an outcome measure. Spinal cord stimulation for the treatment of complex regional pain syndrome: A systematic review of randomized controlled trials. Postherpetic neuralgia mimicking lumbar radiculopathy. Comparing the efficacy of intra-articular injection of Platelet Rich Plasma (PRP) with corticosteroids (CS) in patients with chronic zygapophyseal joint low back pain confirmed by double intra-articular diagnostic blocks: A triple-blinded randomized multicentric controlled trial with a 6-month follow-up.
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