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Torticollis Caused by Nontraumatic Craniovertebral Junction Abnormalities

Authors
Park, S  | Woo, JE | Kim, S  | Yim, SY
Citation
The Journal of craniofacial surgery, 29(5). : 1266-1270, 2018
Journal Title
The Journal of craniofacial surgery
ISSN
1049-22751536-3732
Abstract
Torticollis could be the only symptom and sign of craniovertebral junction (CVJ) abnormality. It could be difficult to identify CVJ abnormality as a cause of torticollis due to their rarity, especially for the subjects with torticollis caused by nontraumatic CVJ abnormalities. There has been no report to focus on nontraumatic CVJ abnormalities as a cause of torticollis. The objective of this study was to report 27 patients of torticollis caused by nontraumatic CVJ abnormalities, with the aim of helping clinicians to identify nontraumatic CVJ abnormalities as a cause of torticollis. This is a retrospective cohort study including 27 subjects who had torticollis caused by nontraumatic CVJ abnormalities. The CVJ was examined in terms of atlanto-occipital angle, atlanto-axial angle, and lateral and anterior atlanto-dens intervals for the evaluation of occipital condylar hypoplasia, rotation of atlanto-axial joint, and lateral and anterior shift of the dens, respectively. Abnormalities of the lower cervical or thoracic spine were also evaluated. Occipital condylar hypoplasia, rotation of atlanto-axial joint, and lateral shift of the dens were the most common CVJ abnormalities. The 18.5% of the subjects had concurrent anomalies of lower cervical or thoracic vertebrae along with CVJ abnormalities. Each subject had 2.22 +/- 1.10 types of CVJ abnormalities on average. In conclusion, comprehensive evaluation of CVJ abnormalities is recommended for differential diagnosis of subjects with unexplained torticollis. Once CVJ abnormalities are identified, concurrent abnormalities of other vertebrae need to be evaluated.
Keywords
MeSH

DOI
10.1097/SCS.0000000000004441
PMID
29905581
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
Journal Papers > School of Medicine / Graduate School of Medicine > Physical Medicine & Rehabilitation
Ajou Authors
김, 상현  |  박, 성훈  |  임, 신영
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