The status of the cervical spine in preschool children with a history of congenital muscular torticollis

Abstract

Background: Infants with congenital muscular torticollis are born with an asymmetric range of motion and a muscular imbalance in the cervical spine, as a result of a shortening or excessive contraction of the sternocleidomastoid muscle. Purpose: The study aimed to investigate passive range of motion (PROM) for rotation and lateral flexion, and muscle function of the cervical spine in children that had a history of CMT as infants. Study design: a prospective cohort study. Patient sample: 58 children at the age of 3.5 to 5 years that had been treated for CMT have infants participated in the study. Method: PROM was measured with protractors and muscle function was estimated with a modified Muscle Function Scale. Data from infancy were taken from earlier records. Result: PROM in rotation of the neck was mean 98.7&#176 and PROM in lateral flexion of the neck was mean 69.1&#176. Symmetric PROM of the neck was found in 74% of the children for rotation and in 88% of the children for lateral flexion. Multiple regression showed that gender and PROM in rotation as infants had a significant impact on asymmetric PROM. Forty-five percent of the children had some degree of muscular imbalance in the lateral flexors of the neck. Conclusion: Possible risk factors for later asymmetric PROM are: gender, birth weight, gestation week and PROM in rotation as infants. These factors ought to be taken into consideration when developing guidelines for long-term follow-up.