PMC7716066_01
Changes in the posture of the patient with dropped head syndrome: (A) before treatment, the patient was obliged to face downward, stretching the neck and showing a chin-on-chest deformity and (B) the patient regained horizontal gaze and compensatory sagittal balance after 4 months of chiropractic care. The center of gravity plumb line (dashed line) is considered the virtual gravity line of the entire body.
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The center of gravity plumb line (COG PL, red dashed line) is considered a virtual gravity line of the entire body (Figure 1A). At the 6-month follow-up, he regained upright posture of the head and global sagittal balance (Figure 1B).
Sagittal EOS  radiographs of the cervical spine: (A) an initial radiograph before treatment revealed reverse lordosis (CobbC2-C7 -16 ), interspace narrowing with grade 1 anterolisthesis at C3/4 and C4/5 levels (blue arrows), C5-C6 ankylosis (hollow arrow), and cervical sagittal imbalance (SVAC2-C7 62 mm) and (B) at 6-month follow-up, the repeat radiograph depicted partial improving cervical curvature and cervical parameters after treatment. SVACOG-C7 offset (red solid line, normal <=30 mm) reduced from 96 mm down to 74 mm and SVAC2-C7 (purple solid line, normal <=40 mm) from 62 mm to 49 mm.. Abbreviations: COG, center of gravity of the head; SVA, sagittal vertical axis.
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Repeat standing full-spine EOS  (Figures 2B and 3B) depicted substantial improving of most of the radiographic parameters except SVAC7-S1.
Postural parameters measured on sagittal standing full-spine EOS : (A) before treatment, a CobbC2-C7 angle <0  was defined as reverse lordosis. Normal range: cervical lordosis 20  to 40 , thoracic kyphosis 20  to 50 , and lumbar lordosis 60 . SVACOG-C7 (red solid line, normal <=30 mm) was 96 mm, indicating occiput-trunk discordance and (B) at 6-month follow-up, most of the radiographic parameters were improved, except SVAC7-S1 offset (white solid line, normal <=30 mm). SVAC7-S1 moved posteriorly (from -37 to -66 mm), indicating negative sagittal balance.. Abbreviations: COG, center of gravity of the head; SVA, sagittal vertical axis.
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Repeat standing full-spine EOS  (Figures 2B and 3B) depicted substantial improving of most of the radiographic parameters except SVAC7-S1.