Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSPMARCON, Raphael MartusONO, Allan Hiroshi de AraujoZELADA, Flavio Gerardo BenitesCRISTANTE, Alexandre FogacaBARROS FILHO, Tarcisio Eloy Pessoa2019-01-172019-01-172018ACTA ORTOPEDICA BRASILEIRA, v.26, n.6, p.415-417, 20181413-7852https://observatorio.fm.usp.br/handle/OPI/30000Objective: To describe a successful surgical treatment for the challenging severe and fixed chin-on-chest deformity due to isolated neck extensor myopathy (INEM). Background data: INEM is an idiopathic cause of dropped head syndrome (DHS) that results in severe cervicothoracic kyphosis, defined as chin-on-chest deformity. The existing literature on surgical management is limited, with outcomes ranging from poor to excellent. INEM may present to the spinal surgeon for consideration of surgical management. Methods: The authors present a technique that uses a staged posterior and anterior approach combined with osteotomies and corpectomy to correct the severe and fixed deformity. A state of the art anterior and posterior instrumentation system was used. Results: At the three-months follow-up, there was good deformity correction and the patient's satisfaction was high, with no neurological deterioration occurring. Conclusions: The technique illustrated in this study represents a successful option to treat this debilitating deformity. More evidence is needed to set up a definitive algorithm for the management of this condition.engopenAccessSurgical procedures operativeSpinal diseasesCervical vertebraeOsteotomyDecompression, surgicaldropped-head syndromemyositismyopathyarticleCopyright ATHA COMUNICACAO & EDITORA10.1590/1413-785220182606169271Orthopedics1809-4406