CHIN ON CHEST SYNDROME
Chin on chest syndrome is a specific type of hyper-kyphosis. Hyper-kyphosis is a spinal deformity in which the upper back curves forward more than normal, creating the appearance of a hump in the back
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Chin on Chest Deformity
A spinal deformity occurs when the spine curves either front-to-back or side-to-side abnormally. The typical human spine has three natural bends when seen from the side. The cervical spine (neck) and lumbar spine (lower back) all have slight inward bends, whereas the thoracic spine (mid-back) has a slight outward curvature. The typical spine is straight and positioned directly above the pelvis when seen from the back. These curves, however, can be accentuated in people with spinal deformities, leading to symptoms including discomfort, weakness, numbness, or tingling that runs down the arms or legs.
The Most Common Conditions Involving Spine Curvature are:
Kyphosis: Excessive spine curvature to the front. A dowager’s hump or hunchback is a term used to describe an unusually rounded upper back. In chest chin syndrome, also called cranium uvula, the kyphosis of the neck and upper back is so severe that the chin drops into the chest. In chest chin syndrome, also called cranium uvula, the kyphosis of the neck and upper back is so severe that the chin drops into the chest.
Lordosis: when the lower back of the spine flexes noticeably inward; also known as swayback
Scoliosis: A spine curvature that resembles an S or C when seen from the back. As vertebrae and discs wear down with age, adult-onset scoliosis, which is less common in children, can develop in persons in their late 50s through their 70s.
Flat back syndrome: when the spine no longer bends naturally
Both adults and children can have spinal deformities. They may exist at birth, or they may result from the consequence of a number of factors, such as an injury, aging-related degenerative changes in the spine, a botched operation, bad posture, heredity, or diseases like osteoporosis or arthritis. Your child’s spinal curvature’s severity and kind will determine how it is treated.
QUESTIONS AND ANSWERS
What causes Chin on Chest Syndrome?
Chin-on-chest syndrome can be caused by various underlying medical conditions. Some common causes include:
- Muscle weakness or atrophy: Conditions like myasthenia gravis, amyotrophic lateral sclerosis (ALS), and inclusion body myositis can lead to muscle weakness in the neck and result in the head drooping forward.
- Cervical spine disorders: Conditions such as cervical spondylosis, cervical disc herniation, or spinal cord compression can affect the neck’s stability and cause the head to droop.
- Neuromuscular disorders: Diseases like Parkinson’s disease or certain types of muscular dystrophy can result in muscle weakness and contribute to this syndrome.
What are the symptoms of Chin on Chest Syndrome?
The primary symptom of chin-on-chest syndrome is the noticeable forward drooping of the head. Other common symptoms may include:
- Neck pain or discomfort
- Difficulty lifting the head or maintaining an upright head posture
- Muscle weakness or fatigue in the neck and upper shoulders
- Limited range of motion in the neck
- Potential difficulty with activities of daily living, such as eating and looking straight ahead
How is Chin on Chest Syndrome Treated?
- Treatment for chin-on-chest syndrome depends on the underlying cause and the severity of the condition. Common treatment options may include:
- Physical therapy: Physical therapists can develop exercises and techniques to strengthen neck muscles and improve head posture.
- Medications: In some cases, medications such as muscle relaxants or immunosuppressants may be prescribed to manage underlying conditions contributing to the syndrome.
- Assistive devices: Neck braces or collars may provide temporary support to help maintain head posture.
- Surgery: If the syndrome is caused by a structural issue in the cervical spine, surgery may be necessary to correct the problem.
- Management of the underlying condition: Treating the root cause, such as managing myasthenia gravis or addressing cervical spine disorders, is essential to improving symptoms.
Fortunately, physical therapy and back bracing may often heal many issues without surgery, while surgery may still be necessary for more severe spinal curvature. It’s critical to consult an orthopedic specialist with experience in treating these disorders since spinal deformity is a complicated issue that needs substantial skill to effectively diagnose and treat.
If you want the very best in Children’s Health, make an appointment with one of our doctors at Medical City Children’s Orthopedics and Spine Specialists
What is Chin on Chest Syndrome?
The spine naturally curves inward at the cervical (or neck region). This inherent curvature may change as a result of neurological issues, illnesses, or trauma. In severe situations, this may result in chin-on-chest syndrome, a medical ailment. As the name suggests, this condition makes it difficult to keep the head upright in a normal position. In reality, the natural position is to rest the chin on the chest. This neuromuscular condition, sometimes referred to as dropped head syndrome (DHS), impairs a person’s quality of life and daily functioning. But what causes puffy syndrome and, most importantly, how can it be treated? First, let’s take a closer look at the cervical spine.
Understanding the Cervical Spine
As you know, the spine consists of a series of bones called vertebrae — from the base of the skull to the tailbone. The spine protects the spinal cord and supports the body while allowing the body to move. There are seven vertebrae that extend from the base of the skull to the upper back that make up the cervical spine. In addition, the spine consists of Intervertebral discs that can, when necessary, isolate and absorb shocks between individual vertebrae. Additionally, many muscles and other soft tissues support the spine. In addition, the facet joints at the back of the spine allow flexion and rotation movements.
Nerve roots leading to the spine exit these joints and extend to the rest of the body. The spinal column contains natural curves that sustain the body’s weight and motions, despite the fact that some people may believe it straight. The cervical spine really has a small inward curve called lordosis. The stability of this curvature depends on the discs, facet joints, muscles, and soft tissues.
Chin on Chest Syndrome
In rare cases, structures in the cervical spine can lose the ability to hold the head upright. As a result, the cervical spine’s natural curvature gets reversed. Moreover, this abnormal curvature increases with progressive structural damage to the spine. Weakness of the neck extensors causes a flexion deformity (inability to straighten the neck).
Symptoms of Chin-on-Chest Syndrome
“Syndrome” refers to a condition with associated symptoms. For example, people with drophead syndrome may experience:
- Alterations in the spine’s appearance
- Typically, the chin rests on the chest.
- Difficulty looking up or keeping the head up straight
- Neck with less range of motion
- A sore neck
- It is simpler to extend the neck while lying down.
- Weakness or numbness throughout the body, including the extremities (i.e. global weakness)
- Being unable to manage one’s bowels or bladder
- Difficulty swallowing or eating
- Horizontal gaze dysfunction
These symptoms may appear quickly or gradually, depending on the underlying reason. In mild cases, many symptoms may not appear. However, severe curvature of the spine that compresses nerves and the spinal cord can cause more serious symptoms.
Causes of Chin-on-Chest Syndrome
The syndrome of the chin on the chest is linked to a number of underlying illnesses. These consist of:
Ankylosing Spondylitis (AS)
A kind of arthritis that damages the joints of the spine. Parts of the spine fuse together as the condition worsens, becoming immovable as a result of new bone formations. AS can also have an impact on the hips, shoulders, ribs, hands, and feet, among other body parts. Environmental and genetic factors in particular can cause this condition.
Parkinson’s disease (PD)
A degenerative nervous system condition that affects the brain’s nerve cells and dopamine levels. Shaking, stiffness, coordination, and balance issues are symptoms of PD. Individuals who have the condition tend to lean forward, which causes structural alterations in the cervical spine.
Rheumatoid Arthritis (RA)
A condition that affects the immune system and results in chronic inflammation throughout the body, including the joints. The body attacks healthy tissues as a result of autoimmune diseases. DHS may develop when the condition worsens and affects the spine.
Amyotrophic Lateral Sclerosis (ALS)
Communication breakdown between the neurological system and muscles is a result of this motor neuron disorder. The outcome is that the muscles, especially those that support the cervical spine, begin to deteriorate.
Strokes:
Neurological damage caused by a stroke can also affect how the brain communicates with the muscles of the neck.
Cancer
Head and neck cancer or the effects of treatment can cause loss of muscle and/or nerve function in the neck.
Cervical Spondylotic Amyotrophy (CSA)
This is a disease that causes degeneration of the cervical spine. CSA compresses the spinal cord and/or nerve roots, causing Pain.
Injuries or previous surgeries to the area: Patients can get Cervical kyphosis after a surgery such as a laminectomy. Additionally, an accident causing a blow to the neck can cause a compression fracture that may change the cervical spine.
Diagnosing the Chin-on-Chest Syndrome
Problem
Correctly identifying the underlying reasons is the first step in successfully treating chin-on-chest conditions. A doctor will first go over your child’s whole medical history and do a comprehensive physical examination. Your general practitioner could suggest you see a medical professional with expertise in neuromuscular disorders like the doctors at Medical City Children’s Orthopedics and Spine Specialists. There are many other tests that the doctor might request, depending on your child’s current health and medical history. Using X-rays or MRIs, your doctor might also want to examine the region more closely. These tests, in particular, can show the damage to your child’s neck.
Treating the Disorder
Treatment options for dropped head syndrome include both conservative and surgical approaches. However, your child’s particular symptoms, causes, and cervical region damage will typically determine the best course of action. The deformity may be reduced and the quality of life may be increased by treating the underlying causes with medicines and a multidisciplinary strategy. The goal of conservative therapies is to lessen symptoms and build up the neck muscles. A child can improve their postural alignment and body motions with the help of physical therapy or physiotherapy. Additionally, physical manipulation and recommended exercises can improve strength and range of motion. Other orthotic aids for pain management and deformity correction include neck braces.
Surgical Options
If your child’s neck deformity is severe and causes persistent discomfort, surgery for cervical kyphosis can be required. Additionally, surgery may be necessary to relieve any pressure on the spinal cord or nerves in order to stop future injury and/or severe neuromuscular issues. A multilevel spinal fusion, for instance, may be necessary for cervical malformation. By permanently joining the compromised vertebrae into a more advantageous position, this operation can rectify the incorrect spinal curvature. A posterior spinal fusion (surgical started from the rear of the neck) is advised for some patients.
As part of the fusion procedure, the spine is aligned and stabilized using bone grafts and other surgical gear. After some time, the afflicted vertebrae join forces and stop the curvature from further deteriorating. Spinal fusion on many levels can be a challenging procedure with a protracted recovery period. A person’s deformities and quality of life may drastically improve as a consequence, though.
The award-winning team of spinal deformity experts at Medical City Children’s Orthopedics and Spine Specialists, with offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX can diagnose and treat chin-on-chest syndrome. To help your child return to a normal life, we’ll use the most recent technological developments and will provide the parents with both non-surgical and surgical solutions.
Footnote:
National Library of Medicine: Chin on Chest Syndrome
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