Min Kyung-Jay, Ahn Ah-Reum, Park Eun-Ji, Yim Shin-Young
The Center for Torticollis, Department of Physical Medicine and Rehabilitation, Ajou University School of Medicine, Suwon, Korea.
Ann Rehabil Med. 2016 Feb;40(1):34-42. doi: 10.5535/arm.2016.40.1.34. Epub 2016 Feb 26.
To identify the correlation between change in spinal deformities after surgical release and age at the time of surgery, and the effectiveness of surgical release in patients with neglected congenital muscular torticollis (CMT).
This was a retrospective study of 46 subjects with neglected CMT who had undergone surgical release at age ≥5 years at a tertiary medical center between January 2009 and January 2014. Spinal deformities were measured on anteroposterior plain radiographs of the cervical and whole spine, both preoperatively and postoperatively, to assess 3 parameters: cervicomandibular angle (CMA), lateral shift (LS), and Cobb angle (CA). We analyzed the change in spinal deformities after surgical release in consideration of age at the time of surgery.
The median age at the time of surgery was 12.87 years. All 3 parameters showed significant improvement after surgical release (median values, pre- to post-surgery: CMA, 12.13° to 4.02°; LS, 18.13 mm to 13.55 mm; CA, 6.10° to 4.80°; all p<0.05). There was no significant correlation between age at the time of surgery and change in CMA (R=0.145, p=0.341) and LS (R=0.103, p=0.608). However, CA showed significant improvement with increasing age (R=0.150, p=0.046).
We assessed the correlation between change in spinal deformities after surgical release and age at the time of surgery. We found that that surgical release is effective for spinal deformities, even in older patients. These findings enhance our understanding of the effectiveness and timing of surgical release in patients with neglected CMT.
确定手术松解后脊柱畸形的变化与手术时年龄之间的相关性，以及手术松解对 neglected 先天性肌性斜颈（CMT）患者的有效性。
这是一项对 46 例 neglected CMT 患者的回顾性研究，这些患者于 2009 年 1 月至 2014 年 1 月在一家三级医疗中心接受了年龄≥5 岁时的手术松解。术前和术后在颈椎和全脊柱的前后位平片上测量脊柱畸形，以评估三个参数：下颌颈角（CMA）、侧方移位（LS）和 Cobb 角（CA）。我们在考虑手术时年龄的情况下分析了手术松解后脊柱畸形的变化。
手术时的中位年龄为 12.87 岁。所有三个参数在手术松解后均有显著改善（中位值，术前至术后：CMA，12.13°至 4.02°；LS，18.13 mm 至 13.55 mm；CA，6.10°至 4.80°；所有 p<0.05）。手术时年龄与 CMA 的变化（R = 0.145，p = 0.341）和 LS 的变化（R = 0.103，p = 0.608）之间无显著相关性。然而，CA 随年龄增长有显著改善（R = 0.150，p = 0.046）。
我们评估了手术松解后脊柱畸形的变化与手术时年龄之间的相关性。我们发现手术松解对脊柱畸形有效，即使在老年患者中也是如此。这些发现增进了我们对 neglected CMT 患者手术松解的有效性和时机的理解。
