| Selective Denervation for Spasmodic Laterocollis : Analysis and Results in 6 Patients |
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Il Seo, Myung-Ki Lee, Sung-Woo Lee, Gun-Sang Lee, Sung-Min Kim, Ho-Sang Kim, Jeong-Ho Kim, Yun-Suk Kim |
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Department of Neurosurgery, Maryknoll Medical Center, Busan, Korea |
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| Abstract |
Objective
This study was to analyze the clinical results following selective peripheral denervation of the levator scapulae muscle (LSM) in patients with spasmodic laterocollis.
Methods
Six patients were retrospectively analyzed. Selective denervation of the spinal accessory nerve to the sternocleidomastoid muscle (SCM), posterior ramisectomy from C1-C6 and the C3 and C4 anterior rami to the LSM were performed on the
ipsilateral side for laterocollis in 3 cases. A staged denervation to the SCM and posterior ramisectomy and then to the LSM in 2
cases, and denervation of the LSM and the SCM in 1 case were carried out. Patients were assessed with Bertrand’s criteria and
the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
Results
The mean duration of the disease was 34.8 months (range, 12-60). The mean age at operation was 46.7 years (range,
34-65). The mean follow-up period was 23.5 months (range, 12-60) after surgery. We obtained an excellent result in 1 case
(16.7%), good in 5 cases (66.6%) with tonic pattern, and poor in 1 case (16.7%) with phasic pattern at the last follow-up after
surgery. The mean TWSTRS total scores were 58.5±4.0 at baseline and were 25.6±16.5 at the last follow-up after surgery. No significant peri-operative complication occurred except for transient disturbance of shoulder elevation and tolerable numbness in
the C2 dermatome.
Conclusion
Selective peripheral denervation of the LSM can offer significant improvement without severe side effects in the treatment of selected patients with spasmodic laterocollis. |
| Key Words:
Levator scapulae muscle, Spasmodic torticollis, Selective peripheral denervation. |
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