| Effect of Selective Peripheral Denervation on Cervical Dystonia with Laterocollis |
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Pei Chi Tsung, Myung Ki Lee, Soon Ki Sung, Jae Meen Lee |
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Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea, Department of Neurosurgery, On General Hospital, Busan, Korea, Department of Neurosurgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea |
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| Abstract |
Objective
The aim of this study was to analyze the clinical effects of selective peripheral denervation involving the levator scapulae muscle (LSM) in 18 patients with cervical dystonia with laterocollis.
Methods
The mean duration of the disease was 35.8 months (range: 12-60). The mean age at operation was 53.7 years
(range: 27-75). Patients were retrospectively evaluated one year after surgery. Selective denervation of the spinal accessory
nerve to the sternocleidomastoid muscle (SCM) and posterior ramisectomy from C1-C6 and the C3 and C4 anterior rami to the
LSM were performed on the ipsilateral side in eight cases. A staged denervation to the SCM and posterior ramisectomy to the
LSM were performed in three cases, and denervation of the LSM and SCM were performed in seven cases. Patients were assessed using Bertrand’s criteria with relief scale using patient self-reporting.
Results
In the 18 cases, results were classified as excellent in five (27.8%), good in ten (55.6%), fair in two (11.1%), and poor in
one (5.5%) at 1 year after surgery. Subjective relief improvement reported by the patient averaged 71.8±22.9%. No significant
peri-operative complications occurred, other than transient disturbance of arm raising and tolerable numbness in the C2 dermatome.
Conclusions
Selective peripheral denervation involving the LSM can offer significant improvement without severe side effects in
the treatment of patients with laterocollis in cervical dystonia. |
| Key Words:
Levator scapulae muscle, Cervical dystonia, Spasmodic torticollis, Selective peripheral denervation. |
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