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Peripheral neurotomy for torticollis: a new approach.
1Department of Neurosurgery, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan. ttaira@nij.twmu.ac.jp
Stereotactic and Functional Neurosurgery
|October 16, 2002
Summary
This study introduces a modified surgical denervation for cervical dystonia, reducing complications and blood loss. The new procedure offers a safer alternative to the traditional Bertrand operation for spasmodic torticollis patients.
Area of Science:
- Neurosurgery
- Neurology
Background:
- Spasmodic torticollis is commonly classified as cervical dystonia.
- Current treatments include chemical or surgical denervation, with intradural ventral rhizotomy and the Bertrand procedure being major surgical options.
Purpose of the Study:
- To present a modified surgical denervation technique for cervical dystonia.
- To compare the safety and efficacy of this modified procedure against the traditional Bertrand procedure.
Main Methods:
- A modified surgical approach combining unilateral intradural ventral rhizotomy (C1-C2), extradural denervation (C3-C6 posterior rami), and contralateral peripheral nerve sectioning was developed.
- Thirty patients (Group A) underwent the modified procedure, compared to 20 patients (Group B) who had the traditional Bertrand procedure.
Main Results:
- The modified procedure resulted in significantly less C2 sensory disturbance (1 patient) compared to the Bertrand procedure (all patients).
- Intraoperative blood loss was significantly lower in Group A.
- Pre- and postoperative outcome scores were comparable between the two groups.
Conclusions:
- The modified surgical denervation technique for cervical dystonia offers a favorable alternative with fewer complications, particularly sensory deficits.
- This approach leads to significantly reduced intraoperative blood loss compared to the traditional Bertrand procedure, enhancing patient safety.