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Dancing Dorsal Quadrilaterals: Case Report.

Francisco de Assis Ulisses Sampaio Júnior1, Hetevaldo Tavares de Lira Filho1, Mateus de Sousa Rodrigues2

  • 1Spine Departament of Sirio-Libanês Hospital, São Paulo, Brazil.

International Journal of Spine Surgery
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Summary
This summary is machine-generated.

A rare case of dancing dorsal quadrilateral syndrome (DDQS) occurred after spinal surgery. This movement disorder involves involuntary muscle contractions, managed with muscle relaxants and botulinum toxin injections.

Keywords:
dyskinesiaperipherally induced movement disorderssurgical

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Area of Science:

  • Neurology
  • Neurosurgery
  • Movement Disorders

Background:

  • Peripheral injury can cause movement disorders, including those from surgical interventions.
  • Dancing Dorsal Quadrilateral Syndrome (DDQS) is an uncommon condition characterized by involuntary movements in the dorsal musculature.
  • Spinal surgery, particularly with instrumentation, is a potential, though rare, trigger for DDQS.

Purpose of the Study:

  • To report a rare case of DDQS following spinal surgery with instrumentation.
  • To describe the clinical presentation, diagnostic findings, and management of DDQS in this patient.

Main Methods:

  • Case report of a 63-year-old male with Scheuermann's disease undergoing thoracic spinal fusion.
  • Post-operative monitoring for pain and involuntary movements.
  • Diagnostic evaluation including motor unit potential analysis.
  • Management involving a neurologist, muscle relaxants, and botulinum toxin injections.

Main Results:

  • The patient developed burning pain and involuntary dorsal muscle movements six months post-surgery.
  • Electromyography showed an ascending-descending pattern of motor unit potentials, consistent with dyskinesia/DDQS.
  • Treatment with muscle relaxants and botulinum toxin resulted in partial symptom improvement.

Conclusions:

  • DDQS is a rare complication of spinal surgery, presenting as focal dyskinesia.
  • Management requires a multidisciplinary approach, including addressing nerve injury and symptomatic treatment with agents like botulinum toxin.
  • Further research is needed to elucidate DDQS pathophysiology and optimize treatment strategies.