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Other Cervical Spine Disorders

Chin is twisted upwards & towards one side

may be Congenital or Acquired

Congenital

  1. Congenital Muscular Torticollis (see below)
  2. Klippel -Feil syndrome

Acquired

may be Osseous or Non-osseous

  1. Osseus, 
    1. Trauma - Atlantoaxial 
    2. Infections
      1. tuberculosis
      2. pyogenic infections
      3. Grisel's syndrome - follows upper respiratory tract infection
    3. Tumours
      1. Osteoid osteoma
    4. Inflammatory
      1. ankylosing spondylitis
      2. Rheumatoid arthritis
    5. Non-osseus
      1. neck burn contractures
      2. ocular - with a superior oblique muscle paresis creating a compensatory head tilt
      3. Prolapsed disc
      4. Tumours 
        1. intraspinal
        2. intracranial - posterior fossa (medulloblastomas, cerebellar astrocytomas, ependymomas)


  • the sternomastoid on one side is fibrous & fails to elongate with growth -> progressive deformity
  • associated with breech & DDH
  • may be due to ischaemia of the muscle from a distorted position in-utero
  • Clinical
    • lump may be noticed in first few weeks of life
    • deformity appears at age 1-2 years
    • sternomastoid feels tight & hard
    • asymmetrical facial development
  • Treatment
    • division of muscle - usually at lower end, but may require division at upper end as well; immobilise with a collar, then stretching exercises


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