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Cervical Spine Dysmorphism in Congenital Muscular Torticollis

 Hussein, Mohammed Ahmed  ;  Yun, In Sik  ;  Lee, Dong won  ;  Park, Hanna  ;  Oock, Kim Yong 
 Journal of Craniofacial Surgery, Vol.29(4) : 925-929, 2018 
Journal Title
 Journal of Craniofacial Surgery 
Issue Date
Cervical Vertebrae*/diagnostic imaging ; Cervical Vertebrae*/pathology ; Cervical Vertebrae*/physiopathology ; Child ; Child, Preschool ; Female ; Humans ; Imaging, Three-Dimensional ; Infant ; Male ; Tomography, X-Ray Computed ; Torticollis/congenital* ; Torticollis/diagnostic imaging ; Torticollis/pathology ; Torticollis/physiopathology
BACKGROUND: Congenital muscular torticollis is a common childhood musculoskeletal anomaly that might result in permanent craniofacial deformity, facial asymmetry, and changes in the cervical vertebrae, if not treated during early childhood. Although there have been many studies on cervical vertebral changes, their onset in children has not been previously studied. METHODS: Fifteen patients (aged <8 years) with a confirmed diagnosed of torticollis were included. Three-dimensional computed tomography scans were obtained, and segmentation of the cervical vertebrae was done. Division of the atlas and axis across the midsagittal plane was done to compare the anatomical changes. The volumes of each halves of the atlas and axis were measured. RESULTS: An apparent change was observed in the axis of the vertebral column when compared with that of the skull. There were progressive anatomical changes affecting the upper cervical vertebrae, which started to develop around the age of 8 months and became more evident in older children. The axis vertebra was the first to be affected. Rotational and bending deformities were the most likely changes to occur. Pearson correlation analysis showed a statistically significant trend in the volume and height changes for both halves of the atlas and axis (P < 0.001 and P < 0.001). CONCLUSIONS: Children with untreated congenital muscular torticollis show progressive anatomical changes of the cervical vertebrae which started at the age of 8 months. The severity of the deformity increased with the advance of age as well as with the severity of sternocleidomastoid tightness, which might result in permanent deformities.
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1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
김용욱(Kim, Yong Oock) ORCID logo https://orcid.org/0000-0002-3756-4809
윤인식(Yun, In Sik) ORCID logo https://orcid.org/0000-0003-1103-7047
이동원(Lee, Dong Won) ORCID logo https://orcid.org/0000-0003-0046-3139
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