Surgical treatment of muscular torticollis for patients above 6 years of age

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.