Severe Chin-on-Chest Cervical Spine Deformity in the Setting of Stiff-Person Syndrome: A Case Report

JBJS Case Connect. 2020 Dec 10;10(4):e20.00378. doi: 10.2106/JBJS.CC.20.00378.

Abstract

Case: Stiff-person syndrome (SPS) presents with progressive muscle rigidity, postural instability, and periodic debilitating spasms. Reports of axial hyperextension exist, but kyphotic deformities have not been described. We surgically treated a patient with debilitating SPS and severe cervicothoracic hyperkyphosis with posterior spinal fusion and instrumentation. At 1-year follow-up, the patient displayed better upright gait and forward gaze, 18° cervical lordosis, and improved patient-reported outcome scores.

Conclusion: SPS can lead to extreme spinal deformity and disease, including hyperkyphosis of the cervicothoracic spine, and can successfully be managed with a multidisciplinary team and a posterior-only correction with spinal instrumentation and fusion.

Publication types

  • Case Reports

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery*
  • Humans
  • Kyphosis / diagnostic imaging
  • Kyphosis / etiology*
  • Kyphosis / surgery
  • Laminectomy
  • Male
  • Middle Aged
  • Osteotomy
  • Spondylolisthesis / diagnostic imaging
  • Spondylolisthesis / etiology*
  • Spondylolisthesis / surgery
  • Stiff-Person Syndrome / complications*
  • Stiff-Person Syndrome / diagnostic imaging
  • Stiff-Person Syndrome / therapy
  • Tomography, X-Ray Computed