Selective peripheral denervation for spasmodic torticollis: 13-year experience with 155 patients

摘要: Object. Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of do not benefit from such therapy, majority respond well but may develop antibodies to after repeated applications. In those termed primary nonresponders, no improvement related botulinum has been shown. whom response was shown and resistance therapy developed, selective peripheral denervation is neurosurgical option. Methods. Between June 1988 August 2001, 155 underwent denervation. Surgery performed at mean 8.5 years onset symptoms (range 0.5–37 years). The age dystonia 39.7 17–77 For evaluation results, patients’ responses were assessed. Results obtained 140 follow-up period ranged 3 124 months (mean 32.8 months): 18 reported complete relief their symptoms, 50 significant relief, 34 moderate relief; 19 noted only minor remaining improvement. results differ substantially when compared previously demonstrated who received injections. 80% secondary nonresponders satisfied result surgery, 62% considered operation helpful. There major side effects. recurrence rate 11%. Conclusions. injection should be first-choice treatment. If surgery required, provides fewest effects all surgical options.