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New Rhizotomy Procedure for Primary Spasmodic Torticollis
Chunhui Hua1, Benfang Pu, Kaizhang Liu
1Department of Neurological Surgery, Tongren Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
The Journal of Craniofacial Surgery
|April 3, 2018
Summary
This study introduces a new surgical technique for spasmodic torticollis (ST). While both surgical groups showed improvement, Group B, undergoing rhizotomy of the spinal accessory nerve (SAN) and anterior C1-C2 nerve roots, demonstrated more significant symptom reduction.
Area of Science:
- Neurology
- Neurosurgery
- Surgical Innovation
Background:
- Spasmodic torticollis (ST) is a debilitating idiopathic neurologic disorder impacting neck muscles.
- Surgical intervention is considered when conservative treatments and botulinum neurotoxin injections prove ineffective.
Purpose of the Study:
- To evaluate the efficacy of a novel surgical approach for treating spasmodic torticollis.
- To compare the outcomes of two surgical variations in ST patients.
Main Methods:
- A retrospective study of 39 ST patients (laterocollis and rotatory subtypes) from June 2014 to June 2015.
- Group A: Rhizotomy of spinal accessory nerve (SAN) and C1-C2 nerve roots with distal SAN coagulation.
- Group B: Rhizotomy of SAN and anterior C1-C2 nerve roots. Surgical outcomes assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
Main Results:
- Both surgical groups showed statistically significant reductions in TWSTRS scores postoperatively (P < 0.05).
- Group B exhibited a more significant decrease in TWSTRS scores compared to Group A.
- Common complications included shoulder numbness, weakness, and hoarseness.
Conclusions:
- The novel surgical procedure offers an effective treatment option for patients with spasmodic torticollis unresponsive to conservative therapies.
- The findings suggest that rhizotomy of the SAN and anterior C1-C2 nerve roots (Group B) may yield superior outcomes.
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