Eighteen patients with congenital muscular torticollis, aged 6-22 (average
11) years, underwent surgical releases:of the contractive bands. There were
8 boys and 10 girls. Preoperative open mouth radiograph of the odontoid pr
ocess in 16 patients showed asymmetry of articular facets of the axis and t
ilt of the odontoid process to the side of the torticollis. Sixteen patient
s received bipolar releases, the others received distal releases. After the
operation, a neck collar was applied and an exercise program was started.
At an average follow-up of 5 years and 7 months,there were excellent or goo
d results in 10 patients, All of the patients except 2 showed improvement o
f the facial asymmetry and all except 1 had a satisfactory range of motion
of the neck. One patient underwent a second operation due to recurrence, Th
e follow-up radiographs showed improvement of the tilt of the odontoid proc
ess,: but the asymmetry of the articular facets of the axis persisted. We s
uggest that bipolar release is the treatment of choice for congenital muscu
lar torticollis in patients of more than 6 years of age. To determine the i
nfluence of a bipolar release on the functions of the cervical spine, longe
r follow-up intervals are needed.