OP
In the case of a therapy-resistant torticollis in children, the decision to undergo surgery is made at the age of 6 at the latest. If the cause is the sternocleidomastoid muscle, it is cut at the base of the collarbone in order to release the muscle tension on the cervical spine. Immobilization for a few weeks is then indicated.
A stabilizing physiotherapy should follow. Orthopaedic causes can usually be treated well surgically. In the case of neurological torticollis, denervation of the affected nerve can be helpful.
In this case, the nerve is sclerosed or severed so that its excessive activity can no longer cause torticollis. This operation is performed only when the treatment with Botox shows no effect. The following topics may also be of interest to you:
- Physiotherapy for nerve root compression
- Pinched nerve in the cervical spine – effects
Botox
Botox (botulinum toxin A) is an enzyme that acts on the synapses that are responsible for the activation of the muscles. The musculature can be relaxed by targeted, dosed application. The use of the nerve toxin must always be precisely dosed and regularly monitored, but in the case of Torticollis spasticus it can improve the symptoms over a period of about 3 months. The problem with long-term treatment with Botox is that the body starts an immune reaction against the foreign enzyme and antibodies can be formed. The application is then no longer possible.
Summary
The torticollis spasticus can be caused by a wide variety of factors. It is often caused by a neurological disorder and can be treated conservatively, with medication, e.g. Botox, or surgically by denervation. It occurs more frequently in adulthood.
The torticollis in newborns can be caused by orthopedic reasons or by a trauma of the sternocleidomastoid muscle. Shortening may occur. Intensive physiotherapy and bedding should be started early to counteract late effects. Especially in the case of a torticollis caused by an acute cervical spine syndrome, mobilizing and relaxing exercises as well as heat applications can provide relief.
