Torticollis: Treatment Options and Surgical Insights

Torticollis issue

I first noticed my torticollis around elementary to middle school.
It wasn't a problem when I was younger, but now that I'm in my senior year of high school, I've always wanted to seek treatment but haven't had the courage to do so.
I don't have any issues like facial asymmetry; I just have a tilted head and a tendency to slouch, which causes my shoulders to be uneven.
Other than that, I don't have any significant problems.
I've heard that surgery can fix it, so I've been considering it lately.
I would like to ask: 1.
Is surgery the only option? 2.
Is it performed under general anesthesia? 3.
How long does the surgery typically take? Thank you! 😊

Xuan, 10~19 year old female. Ask Date: 2016/10/03

Dr. Lai Zhaokang reply Neurosurgery

Hello, general torticollis is often due to fibrosis of the neck muscles.
If you are under 18 years old, it is recommended to first consult a pediatric surgeon (however, there are few specialists in this field, so you may need to search online for the nearest hospital).
If there is involvement of the deeper cervical spinal nerves or spinal cord, then our neurosurgery department may assist.
Best wishes to you from Dr.
Lai Chao-Kang, the Director of the Spine Neurosurgery Department at Changhua Hospital.

Reply Date: 2016/10/03

More Info

Torticollis, commonly known as "wry neck," is a condition characterized by an abnormal, asymmetrical head or neck position. It can be congenital (present at birth) or acquired later in life. The condition can lead to discomfort, pain, and functional limitations, affecting daily activities and overall quality of life. Understanding the treatment options available for torticollis is crucial for individuals seeking relief and improvement in their condition.

1. Surgical vs. Non-Surgical Options: While surgery is one treatment option for torticollis, it is not the only one. Non-surgical treatments often include physical therapy, which can help strengthen neck muscles, improve flexibility, and correct posture. Physical therapy may involve exercises, stretches, and modalities such as heat or ultrasound to alleviate pain and improve function. In some cases, botulinum toxin (Botox) injections may be used to temporarily paralyze the overactive muscles causing the head tilt, providing relief from symptoms. These non-invasive approaches are often recommended before considering surgery, especially for mild to moderate cases of torticollis.

2. Surgical Considerations: If non-surgical treatments do not provide adequate relief, surgery may be considered. The specific type of surgery will depend on the underlying cause of the torticollis. Surgical options may include muscle release or lengthening procedures, which aim to correct the muscle imbalance. It is essential to discuss the potential risks and benefits of surgery with a qualified healthcare provider.
3. Anesthesia and Surgery Duration: Most surgical procedures for torticollis are performed under general anesthesia, meaning you will be asleep during the operation. The duration of the surgery can vary based on the complexity of the procedure but typically ranges from one to three hours. Your surgeon will provide specific information regarding the expected duration based on your individual case.

4. Postoperative Recovery: After surgery, recovery time can vary. Patients may experience some discomfort and will likely need to follow a rehabilitation program to regain strength and mobility in the neck. Physical therapy is often recommended post-surgery to ensure optimal recovery and to prevent recurrence of symptoms.

5. Consultation and Decision-Making: It is crucial to have a thorough evaluation by a healthcare professional specializing in torticollis or related conditions. They can assess your specific situation, discuss the potential causes of your torticollis, and recommend the most appropriate treatment options tailored to your needs.
In summary, while surgery is a viable option for treating torticollis, it is essential to explore non-surgical treatments first. Physical therapy and botulinum toxin injections can provide significant relief for many individuals. If surgery is deemed necessary, it is typically performed under general anesthesia, and the recovery process will involve rehabilitation to ensure the best possible outcome. Always consult with a healthcare provider to make informed decisions regarding your treatment options.

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