Improvements in Nerve Dissection Surgery Methodology for Spasmodic Torticollis Treatment

World Neurosurg. 2021 Dec:156:33-42. doi: 10.1016/j.wneu.2021.08.094. Epub 2021 Aug 28.

Abstract

Spasmodic torticollis is the most common focal dystonia and is characterized by aberrant involuntary contraction of muscles of the neck and shoulders, which greatly affects patients' quality of life. Consequently, patients with this condition often desire treatment to alleviate their symptoms. The common clinical treatments for spasmodic torticollis include interventions such as drug therapy, botulinum toxin injections, and surgery. Surgical treatment is feasible for patients who do not respond well to other treatments or who are resistant to drugs. The gradual improvement of surgeons' understanding of anatomy and the ongoing developments in surgical techniques since their advent in the 1640s have resulted in many innovative surgical approaches that have led to improvements in the treatment of spasmodic torticollis. Previously used surgical treatments that result in uncertain outcomes, various postoperative complications, and serious damage to motor functions of the head and neck have gradually been discontinued. Nerve dissection surgery is the most common surgical treatment for spasmodic torticollis. This article reviews existing research on nerve dissection surgery for the treatment of spasmodic torticollis and the history of its development, along with the advantages and disadvantages of various surgical improvements. This article aims to provide clinicians with practical advice.

Keywords: Intradural transection of nerve roots; Selective peripheral denervation; Spasmodic torticollis.

Publication types

  • Review

MeSH terms

  • Autonomic Denervation / methods
  • Humans
  • Neurosurgical Procedures / methods*
  • Spasm / diagnostic imaging
  • Spasm / surgery*
  • Spinal Nerve Roots / diagnostic imaging
  • Spinal Nerve Roots / surgery*
  • Torticollis / diagnostic imaging
  • Torticollis / surgery*
  • Treatment Outcome