• Wesley H Bronson, Michael J Moses, and Themistocles S Protopsaltis.
• Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York University Langone Medical Center, 301 East 17th Street, New York, NY, 10003, USA.
• Eur Spine J. 2018 Aug 1; 27 (8): 1992-1999.

ObjectiveThe aim of this study is to present our technique for a large focal correction of a partially flexible dropped head deformity through combined anterior and posterior osteotomies, as well as anterior soft tissue releases.MethodsOne patient with dropped head deformity underwent an anterior and posterior osteotomy with anterior soft tissue release.ResultsThe patient recovered well, with postoperative radiographs demonstrating significant improvement in coronal and sagittal alignment. His C2-C7 sagittal vertical axis improved from 7.5 cm preoperatively to less than 4 cm postoperatively and his C2-C7 sagittal Cobb improved from 35° of kyphosis to 10° of lordosis.ConclusionIn this report, we present our technique for a large focal correction of a partially flexible dropped head deformity through combined anterior and posterior osteotomies and anterior soft tissue releases. These more conservative osteotomies permitted gradual deformity correction and alleviated the need for pedicle subtraction osteotomy. We were able to restore horizontal gaze and improve sagittal malalignment. Although the technique we present here is one of many possible options for managing the deformity, we believe this combined approach is safe and effective and well tolerated by patients.

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