Cervical Spine Deformity in Long-Standing, Untreated Congenital Muscular Torticollis

Hussein, Mohammed Ahmed; Yun, In Sik; Park, Hanna; Kim, Yong Oock

doi:10.1097/scs.0000000000003182

Cited by 16 publications

(15 citation statements)

References 15 publications

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“…We believe that young patients have a greater potential for remodeling the scoliosis after surgery and long-standing cases may progress toward a fixed deformity. Using three-dimensional computed tomography, Hussein et al2) demonstrated that there were definitive vertebral deformities along the cervical spine in long-standing patients with CMT. Therefore, we suggest that it may be better to perform surgery for patients with CMT and scoliosis when growth potential remains.…”

Section: Discussionmentioning

confidence: 99%

“…Torticollis is derived from a Latin word meaning twisted neck 12). Congenital muscular torticollis (CMT) is one of the most common types of this condition and is caused by fibromatous contracture of the sternocleidomastoid (SCM) muscle 234). It usually presents with a hard mass within the affected SCM muscle in the neonatal period 1356).…”

mentioning

confidence: 99%

“…However, little is known about the relationship between CMT and secondary scoliosis, and no study has mainly focused on scoliosis in patients with CMT. In the previous few studies on the outcome of patients after surgical treatment of CMT, scoliosis was rarely included in the list of parameters to be evaluated 268). In addition, the evaluation of scoliosis was limited to changes after surgical treatment and the number of patients in these studies was limited 268).…”

mentioning

confidence: 99%

“…In the previous few studies on the outcome of patients after surgical treatment of CMT, scoliosis was rarely included in the list of parameters to be evaluated 268). In addition, the evaluation of scoliosis was limited to changes after surgical treatment and the number of patients in these studies was limited 268). Therefore, our study focused on the development of scoliosis in patients with CMT, and the changes that might occur to the scoliosis after surgical release in these patients.…”

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confidence: 99%

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Secondary Cervicothoracic Scoliosis in Congenital Muscular Torticollis

2019

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Background Although secondary cervicothoracic scoliosis frequently occurs in patients with congenital muscular torticollis (CMT), the relationship between scoliosis and CMT has not been evaluated. This study aims to evaluate the effects of surgical release of sternocleidomastoid (SCM) muscle on secondary cervicothoracic scoliosis in patients with CMT and determine factors affecting the improvement of scoliosis after surgical release of SCM muscle. Methods Eighty-seven of the 106 patients, confirmed as having secondary cervicothoracic scoliosis with CMT with a minimum 1-year follow-up, were included in this study. Preoperative and last follow-up radiologic outcomes were assessed for the cervicomandibular angle (CMA), Cobb angle of the cervicothoracic scoliosis, and direction of convexity in the scoliosis curve. Patients were divided into two groups to assess the improvement of Cobb angle according to residual growth potential; age ≤ 15 years and > 15 years. The improvement of Cobb angle after surgical release was compared in the two groups. Correlation analysis and multivariable regression analysis were performed to determine the factors affecting the improvement of scoliosis. Results All the radiologic parameters, such as the Cobb angle and CMA, improved significantly after surgical release ( p < 0.001). The improvement of Cobb angle was significantly higher in age ≤ 15 years than in age > 15 years ( p < 0.001). The improvement of Cobb angle was significantly correlated with age ( r = −0.474, p < 0.001) and the preoperative Cobb angle ( r = 0.221, p = 0.036). In multivariable regression analysis, age and preoperative Cobb angle were shown to be predisposing factors affecting the improvement of scoliosis. Conclusions The results showed that SCM release can be a beneficial treatment for secondary cervicothoracic scoliosis. The improvement of scoliosis was greater when the SCM release was performed before the patient reached the end of growth.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Secondary Cervicothoracic Scoliosis in Congenital Muscular Torticollis

2019

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“…From the above process, patients with congenital torticollis were divided into the following four groups: ocular torticollis, defined as torticollis caused by ophthalmic conditions, such as disorders of ocular movement and nystagmus [ 10 , 11 ]; neurogenic torticollis, defined as abnormal head and neck posture due to associated neurologic abnormalities that weakens the neural connections required for proper head and neck positioning (e.g., cerebral palsy) [ 11 , 12 ]; osseous torticollis, defined as torticollis associated with congenital malformation of the spine such as vertebral segmentation defects [ 11 , 13 , 14 , 15 ]; and CMT, diagnosed by evidence of shortening of the SCM muscle via physical examination and/or enlarged thickness, heterogeneous echogenicity, fibromatous lesion, or asymmetry of the SCM muscle on sonographic findings. The diagnosis of CMT included tumor, muscular, and postural types [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

Section: Methodsmentioning

confidence: 99%

Congenital Osseous Torticollis that Mimics Congenital Muscular Torticollis: A Retrospective Observational Study

et al. 2020

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It may be difficult to diagnose congenital osseous torticollis based on physical examinations or plain X-rays, especially when children have no other accompanying congenital defects. This study reports the children with torticollis caused by the vertebral anomaly with the symptom of abnormal head and neck posture only. We retrospectively reviewed the records of 1015 patients diagnosed with congenital torticollis in a single tertiary hospital (Incheon St. Mary’s Hospital, Korea) who were referred from a primary local clinic. We included those with deficits in passive range of motion (PROM) of neck. Ultrasonography of the sternocleidomastoid (SCM) muscles, ophthalmologic and neurologic examinations, and cervical X-rays were performed for all patients. If bony malalignment was suspected from X-ray, three-dimensional volume-rendered computed tomography (3D-CT) was performed. Ten patients were diagnosed with osseous torticollis with no defect other than bony anomalies. Although X-ray images were acquired for all patients, vertebral anomalies were definitely confirmed in three cases (30.0%) only, and the others (70.0%) were confirmed by CT. The most common type of vertebral anomaly was single-level fusion. Identifying congenital vertebral anomalies is challenging especially when the degree of invasion is only one level. Although abnormal findings on X-rays may be subtle, a careful examination must be performed to avoid misdiagnosis.

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