Surgical release of congenital torticollis in adults.

Longstanding untreated congenital torticollis in adults is uncommon and surgical release in such a case can be hazardous or fraught with many possible complications. A two-stage, open, bipolar surgical division of the contracted sternocleidomastoid muscle in a 33-year-old woman who developed pain and paresthesiae in the neck and arm was performed under general then local anesthesia. Surgery then controlled gradual stretching in a halo-vest achieved complete subsidence of pain, a near-full range of neck motion and correction of the tilt deformity, without complication. The facial asymmetry and the underlying fixed skeletal changes remained. Surgical release and gradual correction in a halo apparatus can eliminate the need for major spinal surgery in the correction of longstanding torticollis.