Modified McKenzie procedure for the treatment of fixed painful torticollis.

Spasmodic torticollis is characterized by involuntary movements of the neck muscles. In this video, the authors present the case of a 48-year-old man with painful right-sided rotational torticollis with contributions from both the suboccipital and the left sternocleidomastoid (SCM) muscles. He underwent a suboccipital craniectomy and C1-2 laminectomy with selective denervation of bilateral suboccipital and left-sided SCM muscles (modified McKenzie procedure). At the 2-week follow-up, he showed significant improvement and was able to rotate his neck about 70° toward the midline. Surgical treatment of spasmodic torticollis focuses on interrupting the motor pathway responsible for head turning. The modified McKenzie procedure is valuable, especially when other therapies fail. The video can be found here: https://youtu.be/TK-WybKnGJM.