{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:29:26Z","timestamp":1787318966936,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Ponticulus posticus (PP) occurs frequently and may cause symptom series, including vertebrobasilar insufficiency, migraine, hearing loss, and Barr\u00e9\u2010Li\u00e9ou syndrome. However, few studies to date have described surgical treatment of PP. We report a rare case of a patient who suffered from torticollis, facial asymmetry, localized pain, and Barr\u00e9\u2010Li\u00e9ou syndrome in connection with PP\n                      <jats:italic>.<\/jats:italic>\n                      We also review the pertinent literature, focusing on surgical treatment for symptoms due to PP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 23\u2010year\u2010old male presented with the chief complaint of continuous significant dizziness to the point of losing consciousness while rotating his head to the right. Plain radiographs and computed tomography (CT) scans of the cervical spine showed a \u04211 anomaly with the formation of complete PP on the left (dominant) side, with acute\u2010angled, \u0421\u2010shaped kinking of the vertebral artery. Resection of PP\n                      <jats:italic>via<\/jats:italic>\n                      the posterior midline was performed successfully. The patient had satisfactory postoperative relief from localized pain and Barr\u00e9\u2010Li\u00e9ou syndrome, but there were no obvious changes in the torticollis and facial asymmetry observed during the 3\u2010month follow\u2010up period.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case is a rare presentation of torticollis, facial asymmetry, localized pain, and Barr\u00e9\u2010Li\u00e9ou syndrome in connection with one\u2010sided complete PP. This tetrad indicates that PP may affect the patient earlier than expected. In such situations, early diagnosis and timely surgical treatment may significantly improve patients' quality of life and avoid the development of torticollis and face asymmetry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/os.13267","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T03:27:20Z","timestamp":1650857240000},"page":"1235-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Torticollis, Facial Asymmetry, Local Pain, and\n                    <scp>Barr\u00e9\u2010Li\u00e9ou<\/scp>\n                    Syndrome in Connection with\n                    <scp>One\u2010Sided<\/scp>\n                    Ponticulus Posticus: A Case Report and Review of the Literature"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9705-8537","authenticated-orcid":false,"given":"Guangzhou","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaoju","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University  Luzhou 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