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[Objective evaluation of selective peripheral denervation for spasmodic torticollis]
T Taira1, H Kawamura, T Tanikawa
1Department of Neurosurgery, Tokyo Women's Medical College.
No Shinkei Geka. Neurological Surgery
|October 23, 1997
Summary
Selective peripheral denervation (SPD) effectively treats spasmodic torticollis, showing superior symptom control compared to botulinum toxin (BTX). Some patients experienced a "mole-hitting game phenomenon" requiring further surgery.
Area of Science:
- Neurosurgery
- Neurology
- Orthopedics
Context:
- Spasmodic torticollis is a debilitating neuromuscular condition.
- Current treatments include botulinum toxin (BTX) injections and surgery.
- Selective peripheral denervation (SPD) offers a surgical alternative.
Purpose:
- To evaluate the efficacy of selective peripheral denervation (SPD) for spasmodic torticollis.
- To compare SPD outcomes with botulinum toxin (BTX) treatment efficacy.
- To report on potential complications, including the 'mole-hitting game phenomenon'.
Summary:
- Five patients underwent seven SPD procedures targeting cervical spinal nerves and/or the accessory nerve.
- The modified Tsui's score significantly improved post-operatively (10.8 to 1.4), indicating excellent/good results in all five patients.
- SPD demonstrated superior symptom control compared to BTX, though two patients developed the 'mole-hitting game phenomenon', necessitating repeat operations.
Impact:
- SPD is a highly effective surgical treatment for spasmodic torticollis, offering significant symptom improvement.
- This study highlights SPD's potential superiority over BTX in symptom management for spasmodic torticollis.
- The report is likely the first to describe the 'mole-hitting game phenomenon' in surgically denervated cases, informing future surgical strategies.