Selective peripheral denervation of the levator scapulae muscle for laterocollic cervical dystonia

Laterocollis, as a symptom of idiopathic cervical dystonia may be due to abnormal contraction of the levator scapulae muscle (LSM). The purpose of this study is to define the effects of selective peripheral denervation of LSM in patients with laterocollic cervical dystonia.The clinical records of 10 patients who underwent LSM denervation for laterocollic torticollis were reviewed. Preoperatively, all patients showed sustained lateral tilt of the head and elevation of the shoulder. Abnormal contraction of LSM was observed and the muscle was denervated surgically in the posterior cervical triangle. The mean age at operation was 38.4 years (range, 20-58 years) and the mean duration of the symptom ranged from 14 to 80 months (mean, 41months). The postoperative follow up ranged from 6 to 72 months (mean, 29.4months). The cervical dystonia rating score of Tsui was 10.8 on average before the operation, and the postoperative follow up score was 1.3. According to the changes of the rating score, success rates, including excellent and good results, were 40% and 60%, respectively. Five patients (50%) postoperatively showed transient dysaesthesia in the neck. There was no disturbance of shoulder elevation or arm raising. When abnormal contraction of LSM is responsible for laterocollis in patients with cervical dystonia, selective peripheral denervation of this muscle is a safe and effective procedure for alleviation of the symptom.