Selective Peripheral Denervation for the Treatment of Spasmodic Torticollis.

Jang, Kyung Sool; Park, Hea Kwan; Joo, Won Il; Ji, Chul; Lee, Kyung Jin; Choi, Chang Rak

Original Article

Journal of Korean Neurosurgical Society 2005;37(5): 350-353.

Kyung Sool Jang, Hea Kwan Park, Won Il Joo, Chul Ji, Kyung Jin Lee, Chang Rak Choi

Department of Neurosurgery, Catholic Neuroscience Center, The Catholic University of Korea, Seoul, Korea. rhalee@catholic.ac.kr

ABSTRACT

OBJECTIVE
Various methods of treatment for idiopathic cervical dystonia have been tried in the past with unsatisfactory results. The authors report cases of five patients who underwent selective peripheral denervation for spasmodic torticollis. METHODS: Between July 2002 and December 2003, 5 patients underwent surgery at St. Mary's Hospital for spasmodic torticollis. Age of the patient at the onset of symptoms ranged from 29 to 56years (mean 43.75years). Selective peripheral denervation(SPD) was performed at 7 to 11months after the onset of symptoms (mean 8.75 months). A patient was considered to be the candidate for surgery if conservative methods were unsuccessful and symptoms persisted for longer than 7months. In addition, 2patients who refused treatment with botulinum toxin were also enrolled in this study. RESULTS: Although one patient underwent reoperation, all of the five patients' symptoms were improved after the operation. Clinically, patients with retrocollis showed better improvement than laterocollis patients. CONCLUSION: Although injection of botulinum toxin is the first-choice in treatment modality, when surgery is required, selective peripheral denervation provides good results with minimum side effects.

Key Words: Spasmodic torticollis; Cervical dystonia; Selective peripheral denervation; Botulinum toxin