World Journal of Endocrine Surgery

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VOLUME 14 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Spasmodic Torticollis after Endoscopic Thyroidectomy: A Case Report

Sanjay Kumar, Gyan Chand, Anjali Singh, Sandeep Khuba

Keywords : Bilateral axillo-breast approach endoscopic thyroidectomy, Endoscopic thyroid surgery, Spasmodic torticollis, Trigger point neutralization

Citation Information : Kumar S, Chand G, Singh A, Khuba S. Spasmodic Torticollis after Endoscopic Thyroidectomy: A Case Report. World J Endoc Surg 2022; 14 (2):63-65.

DOI: 10.5005/jp-journals-10002-1433

License: CC BY-NC 4.0

Published Online: 15-04-2023

Copyright Statement:  Copyright © 2022; The Author(s).


Aim: Management of spasmodic torticollis after endoscopic thyroidectomy. Background: Spasmodic torticollis is a disorder of movement of neck musculature characterized by involuntary posturing of the head. This results in postural deviations of the head and intermittent or continuous diffuse pain (70–80%) in the area of the neck and shoulder region associated with stiffness. Numerous neck complaints are present in patients who have undergone thyroid surgery, and even after surgery, this discomfort may continue for a long time and become severe if there is a lack of movement of the neck and shoulders postsurgery. At present, the most used endoscopic thyroidectomy method is the bilateral axillo-breast approach endoscopic thyroidectomy (BABA-ET). Case description: We report a case of a 44-year-old female who underwent BABA-ET and 6 months later came with a complaint of pain over the right and front of the neck associated with the sensation of burning, pinpricking, and numbness. The patient was posted for trigger point injection of the right-side sternocleidomastoid and front of neck under ultrasonography and advised for neck stretching exercises along with physiotherapy. On follow-up patient weeks later, the patient reported improvement in pain scores, no neuropathic features, as well as stiffness, and profound improvement in range of motion, which continued for 6 months. Conclusion: Myofascial trigger point neutralization followed by physical therapy significantly alleviates symptoms; therefore, it is a safe, minimally invasive, and diagnostic as well as a therapeutic modality in torticollis. Clinical significance: Neck surgeries predispose patients to neck myofascial pain and the development of trigger points, which may manifest as disturbed motor function in the form of muscle stiffness, weakness, restricted range of motion, and pain. Identifying the culprit's muscle and, along with it, physical therapy and trigger point neutralization helps in a significant reduction in pain and motor activity and improve overall wellbeing.

  1. Smith DL, DeMario MC. Spasmodic torticollis: a case report and review of therapies. J Am Board Fam Pract 1996;9(6):435–441. DOI: 10.3122/jabfm.9.6.435
  2. Velickovic M, Benabou R, Brin MF. Cervical dystonia pathophysiology and treatment options. Drugs 2001;61(3):1921–1943. DOI: 10.2165/00003495-200161130-00004
  3. De Pauw J, Van der Velden K, Meirte J, et al. The effectiveness of physiotherapy for cervical dystonia: a systematic literature review. J Neurol 2014;261(10):1857–1865. DOI: 10.1007/s00415-013-7220-8
  4. Takemoto M, Ikenaga M, Tanaka C, et al. Cervical dystonia induced by cervical spine surgery: a case report. Spine (Phila Pa 1976) 2006;31(1):E31–E34. DOI: 10.1097/01.brs.0000193928.16048.cb
  5. de Vries LH, Aykan D, Lodewijk L, et al. Outcomes of minimally invasive thyroid surgery - a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2021;12(12):719397. DOI: 10.3389/fendo.2021.719397
  6. Takamura Y, Miyauchi A, Tomoda C, et al. Stretching exercises to reduce symptoms of postoperative neck discomfort after thyroid surgery: prospective randomized study. World J Surg 2005;29(6):775–779. DOI: 10.1007/s00268-005-7722-3
  7. Gaspersic R, Koritnik B, Erzen I, et al. Muscle activity-resistant acetylcholine receptor accumulation is induced in places of former motor endplates in ectopically innervated regenerating rat muscles. Int J Dev Neurosci 2001;19(3):339–346. DOI: 10.1016/s0736-5748(01)00018-1
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