Dropped head syndrome after multilevel cervical radiofrequency ablation: a case report.

STUDY DESIGN: Case report. OBJECTIVE: To describe a serious complication of multilevel radiofrequency ablation (RFA) of the cervical spine. SUMMARY OF BACKGROUND DATA: Percutaneous RFA is an accepted nonoperative modality for the treatment of neck pain. When the procedure is performed according to established guidelines, serious adverse events are rare. METHODS: The authors performed a clinical and radiographic case review. RESULTS: A 54-year-old woman presented with neck pain and weakness with cervical kyphosis. She had undergone left-sided RFA of the third occipital nerve and C2-C4 facet joints 8 weeks prior to presentation. The patient was incapable of extending her neck, although the deformity was passively correctable. Imaging revealed no lesions to which the kyphosis could be attributed. As the deformity progressed over the subsequent 3 months, surgery was recommended. An instrumented posterior fusion from C2 to T2 was performed with correction of the chin-on-chest deformity and improvement in the patient's axial neck pain. CONCLUSIONS: Dropped head syndrome is a rare yet potentially debilitating complication of multilevel cervical RFA.