Serial radiographic follow-up of severe chin-on-chest posture associated with acute cervical disc herniation treated with Korean medicine: a case report

Background Chin-on-chest posture is usually associated with neuromuscular disorders or structural cervical kyphosis, and its occurrence as a reversible, pain-related deformity after acute cervical disc herniation is rarely reported, particularly with serial radiographic documentation of recovery. Case presentation A 64-year-old man developed a severe chin-on-chest posture with markedly limited cervical extension after acute C6–C7 cervical disc herniation. Surgery was recommended but declined, and his symptoms did not improve after an epidural steroid injection. From one week after onset, he received stepwise traditional, complementary, and integrative medicine, including acupuncture, pharmacopuncture, Chuna manual therapy, and herbal medicine, during a 38-day hospitalization followed by 2 months of outpatient care. Outcomes were assessed using the NRS, NDI, EQ-5D, cervical range of motion, and serial lateral radiographs (C2–C7 SVA and Cobb angle). At the 2-month follow-up, standardized clinical outcomes were not reassessed; radiographic and qualitative clinical follow-up information was available. Results The NRS decreased from 8 to 4, the NDI from 55.6 to 20, and the EQ-5D increased from 0.692 to 0.862, while cervical extension recovered from 0° to 20°. On serial radiographs, the C2–C7 SVA decreased from 78.03 mm at admission to 55.57 mm at discharge and 38.24 mm at the 2-month follow-up, and the Cobb angle from 24.18° to 7.38° and 4.28°, respectively, indicating gradual resolution of the chin-on-chest posture. Conclusion This case documents spontaneous and treatment-associated recovery of a severe, apparently reversible chin-on-chest posture during multimodal conservative care; the contribution of individual interventions cannot be determined.