Age Group-Specific Improvement of Vertebral Scoliosis after the Surgical Release of Congenital Muscular Torticollis

Abstract

Background Congenital muscular torticollis (CMT) is a common musculoskeletal disorder in children. Secondary scoliosis can occur in patients with CMT; however, the extent of inclination and improvement of scoliosis after surgical correction of CMT have not been adequately studied. In this study, we aimed to evaluate and measure the improvement in vertebral tilting after surgical correction according to age at the time of surgery.

Methods Between June 2007 and January 2020, 831 patients with CMT underwent sternocleidomastoid release. Among them, 426 patients were enrolled, and their medical records were retrospectively reviewed. Ultimately, 210 patients available for radiological evaluation and analysis were enrolled in this study. The patients were divided into four groups according to age at the time of surgery to determine the relationship between age and changes in scoliosis.

Results Our findings showed an improvement in scoliosis in all age groups after surgery. The results for follow-up after 1 year confirmed long-term improvement in vertebral tilting. The degree of improvement in scoliosis was significantly higher in the younger age group than in patients aged 18 years or older.

Conclusion The effect of surgical release on scoliosis was significant in all age groups. The findings of this study suggest that CMT should be corrected before the age of 3 years to ensure an optimal surgical mitigation of scoliosis. Furthermore, in cases of neglected CMT, surgical release should be actively attempted because there is significant improvement.

Keywords

torticollis - neck muscles - surgical procedures - operative - scoliosis

Authors' Contributions

Conceptualization: J.M.C. and S.H.S. Data curation: M.C.P. Formal analysis: J.M.C., S.H.S., and M.C.P. Methodology: J.M.C., C.M.C., and J.H.K. Project administration: S.H.S. Visualization: C.M.C. and J.H.K. Writing—original draft: S.H.S. and J.M.C. Writing—review and editing: J.M.C., S.H.S., and M.C.P. All authors read and approved the final manuscript.

Ethical Approval

This study was approved by the Institutional Review Board of Hallym Sacred Heart Hospital (IRB No. 2021-12-003-003) and performed in accordance with the principles of the Declaration of Helsinki.

Patient Consent

Informed consent was taken from patients for the evaluation of imaging studies.

Publikationsverlauf

Eingereicht: 14. November 2022

Angenommen: 01. September 2023

Accepted Manuscript online:
06. September 2023

Artikel online veröffentlicht:
07. Februar 2024

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