Krivosheya: methods of surgical treatment

The treatment of torticollis should be started as soon as possible, namely immediately after diagnosis. The ideal time for the beginning of the medical process is 2-3 weeks old child. If the beginning of treatment of this disease is delayed, then it is possible to encounter the rapid development of compensatory reactions in the baby's body. In other words, if you remain inactive, the nodding muscle will become shorter, and the inclination and rotation of the head and the facial and cranial asymmetry will progress. And in time, the treatment started can stop these processes.

Treatment - surgical intervention

The treatment of torticollis is determined by specialists. For example, if a cicatricial shortening of the nipple muscle is manifested, they are sent to a plastic operation to restore the correct position of the head. Surgical treatment of this disease usually begins after a year, but in the first year of life of the baby, starting from 2-3 weeks of age, prescribed massage and exercise therapy. These procedures help to make better nutrition, that is, the blood supply to the affected muscle, significantly accelerate the resorption of hematomas, when there is a birth injury and prevent scarring.

Microvascular decompression of the accessory nerve

There is also a method of surgical treatment of torticollis - microvascular decompression of the accessory nerve. This operation is quite unusual and complicated.

It should be noted that the American surgeon Peterson after performing a one-way microvascular decompression of the accessory nerve achieved 30 percent of excellent results, and the surgeon Axik in 1988 after conducting bilateral microvascular decompression of the accessory nerve increased the percentage of positive results by 2 and half. Similar results, namely 84% of the positive results, were received by Russian surgeons.
During the operation, various interrelations of the accessory nerve with the vessels of the vertebrobasilar basin were identified, subdivided into lower anterior and upper rear types of compression of the accessory nerve.

When comparing the type of compression with the desired data, it was found that with lower forward compression, the predominance of the trapezius muscle activity occurs, and with the upper back the predominance of the nipple muscle arises. Such data are fully consistent with the results of EMG studies with stimulation of the roots, which goes separately, forming an additional nerve.

The process of performing the operation

The decompression of the intradural part of the accessory nerves is carried out by crossing its anastomoses with roots that are very sensitive and terminal toothed ligament, transposing the caudal loop. Cross connective tissue bridges that divert the extra nerve as a median to the cerebellum hemisphere. Venous compression is removed by vein coagulation, and then there is its intersection. Intersection of the terminal dentate ligament is performed in the case when there is compression of the accessory nerve of the ICA and the initial sections of the ZNMA and they pass between the dentate ligament and this additional nerve. Between the nerve and the vessel that squeezes it, a gasket is installed - a synthetic or a piece of muscle with a size of 3x5 mm. The protector, which is installed, makes the pulse pressure softer, or moves the arteries to the side. These actions completely eliminate their contacting process. The process of elimination of vascular compression reveals the possibility of remyelination of the diseased part of the nerve and removes the focus of pathologically manifested excitation in the nucleus of the accessory nerve for 4-5 months after surgery.

Age authorized for operation

It is worth remembering that the disease of torticollis, the methods of surgical treatment are conducted at the age after 1 year. The operation is determined by the causes of the development of this disease - torticollis. Operative treatment is usually shown from the age of 3 years of the child, after the operation on the neck, a collar of gypsum is applied. The results in time of the initiated treatment process are favorable.