Choi Jong Min, Seol Seong Hoon, Kim Jae Hyun, Chung Chan Min, Park Myong Chul
Department of Plastic and Reconstructive Surgery, Hallym Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Arch Plast Surg. 2024 Feb 7;51(1):72-79. doi: 10.1055/a-2168-4606. eCollection 2024 Jan.
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. 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. 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. 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.
先天性肌性斜颈(CMT)是儿童常见的肌肉骨骼疾病。CMT患者可能会出现继发性脊柱侧弯;然而,CMT手术矫正后脊柱侧弯的倾斜程度及改善情况尚未得到充分研究。在本研究中,我们旨在根据手术时的年龄评估和测量手术矫正后椎体倾斜的改善情况。
2007年6月至2020年1月期间,831例CMT患者接受了胸锁乳突肌松解术。其中,426例患者被纳入研究,并对其病历进行回顾性分析。最终,210例可进行影像学评估和分析的患者被纳入本研究。根据手术时的年龄将患者分为四组,以确定年龄与脊柱侧弯变化之间的关系。
我们的研究结果显示,所有年龄组术后脊柱侧弯均有改善。1年后的随访结果证实椎体倾斜有长期改善。较年轻年龄组脊柱侧弯的改善程度明显高于18岁及以上患者。
手术松解对所有年龄组的脊柱侧弯均有显著效果。本研究结果表明,CMT应在3岁前矫正,以确保脊柱侧弯得到最佳手术缓解。此外,对于被忽视的CMT病例,应积极尝试手术松解,因为会有显著改善。