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Microvascular decompression for spasmodic torticollis

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Summary

Twenty patients with spasmodic torticollis (ST) were treated by microvascular decompression (MVD) of the spinal accessory nerves, the upper cervical nerve roots and the brainstem. Thirteen were female and seven male. Median age was 47 years (range 39 to 70 years). Median duration of symptoms was 5 years (range 4 months to 17 years). Ten had right horizontal; nine, left horizontal; and one, retrocollis ST. Twenty-two operations were performed on twenty patients, suboccipital craniectomy and C1 laminectomy in 18 and retromastoid craniectomy in 4 operations.

The most common compressing blood vessels were the vertebral artery and/or the posterior inferior cerebellar artery. No nerve section was performed. Three patients died of unrelated conditions, 3, 5 1/2, and 6 years postoperatively, respectively. Minimum follow-up period in the rest of the cases is 5 years (range 5 to 10 years). Thirteen (65%) were cured, four (20%) improved with minimal spasm, one (5%) improved with moderate spasm, and two (10%) improved minimally or unchanged. In most cases the cure or improvement was noticed gradually over 6 months to two years following the operation.

There was no operative mortality. Postoperative morbidities included transient cerebrospinal fluid leakage through the surgical incision in one case and an apparent multiple small vessel stroke involving periventricular white matter in one reoperation case with full recovery.

MVD for ST is a nondestructive benign procedure with high probability of cure or significant improvement.

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References

  1. Bertrand C, Molina-Negro P, Bouvier G, Gorczyca W (1987) Observations and analysis of results in 131 cases of spasmodic torticollis after selective denervation. Appl Neurophysiol 50: 319–323

    PubMed  Google Scholar 

  2. Colbassani HJ Jr, Wood JH (1986) Management of spasmodic torticollis. Surg Neurol 25: 153–158

    PubMed  Google Scholar 

  3. Duane DD (1988) Spasmodic torticollis. Advances in neurology 49: 135–149

    PubMed  Google Scholar 

  4. Foltz EL, Knapp LM, Ward AA Jr (1959) Experimental spasmodic torticollis. J Neurosurg 16: 55–72

    PubMed  Google Scholar 

  5. Foerster O (1933) Mobile spasm of the neck muscles and its pathological basis. J Comp Neurol 58: 725–725

    Google Scholar 

  6. Freckmann N, Hagenah R, Herrmann H-D, Muller D (1981) Treatment of neurogenic torticollis by microvascular lysis of the accessory nerve roots-indication, technique, and the first results. Acta Neurochir (Wien) 59: 167–175

    Google Scholar 

  7. Freckmann N, Hagenah R, Herrmann H-D, Muller D (1986) Bilateral microsurgical lysis of the spinal accessory nerve roots for treatment of spasmodic torticollis. Follow-up of 33 cases. Acta Neurochir (Wien) 83: 47–53

    Google Scholar 

  8. Freckmann N, Hagenah R (1986) Relationship between the spinal accessory nerve and the posterior root of the first cervical nerve in spasmodic torticollis and common autopsy cases. Zentralbl Neurochir 47: 134–138

    PubMed  Google Scholar 

  9. Herz E, Glaser GH (1949) Spasmodic torticollis: clinical evaluation. Arch Neurol Psychiatry 61: 227–239

    Google Scholar 

  10. Huygen PLM, Verhagen WIM, VanHoof JJM, Horstink MWIM (1989) Vestibular hyperactivity in patients with idiopathic spasmodic torticollis. J Neurol Neurosurg Psychiatry 52: 782–785

    PubMed  Google Scholar 

  11. Kaste M, Livanainen M, Juntunen J, Setala A (1981) Brain involvement in spasmodic torticollis. Acta Neurol Scand 63: 373–380

    PubMed  Google Scholar 

  12. Lal S (1979) Pathophysiology and pharmacotherapy of spasmodic torticollis: a review. Can J Neurol Sci 6: 427–435

    PubMed  Google Scholar 

  13. Lowenstein DH, Aminoff MJ (1988) The clinical course of spasmodic torticollis. Neurology 38: 530–532

    PubMed  Google Scholar 

  14. Matthews WB, Beasley P, Parry-Jones W, Garland G (1978) Spasmodic torticollis: a combined clinical study. J Neurol Neurosurg Psychiatry 41: 485–492

    PubMed  Google Scholar 

  15. Meares R (1971) Natural history of spasmodic torticollis, and effect of surgery. Lancet 2: 149–150

    PubMed  Google Scholar 

  16. Motomochi M, Makita Y, Nabeshima S, Itagaki T, Tei T, Imataka K (1983) Spasmodic torticollis: surgical treatments and long-term results. Neurol Med Chir (Tokyo) 23: 741–746

    Google Scholar 

  17. Nagata K, Matsui T, Joshita H, Shigeno T, Asano T (1989) Surgical treatment of spasmodic torticollis: effectiveness of microvascular decompression. No To Shinkei 41: 97–102

    PubMed  Google Scholar 

  18. Nakashima K, Thompson PD, Rothwell JC, Day BL, Stell R, Marsden D (1989) An exteroceptive reflex in the sternocleidomastoid muscle produced by electrical stimulation of the supraorbital nerve in normal subjects and patients with spasmodic torticollis. Neurology 39: 1354–1358

    PubMed  Google Scholar 

  19. Pagni CA, Naddeo M, Faccani G (1985) Spasmodic torticollis due to neurovascular compression of the 11th nerve. Case report. J Neurosurg 63: 789–791

    PubMed  Google Scholar 

  20. Patterson RM, Little SC (1943) Spasmodic torticollis. J Nerv Ment Dis 98: 571–599

    Google Scholar 

  21. Plant GT, Kermode AG, du Boulay EPGH, McDonald WI (1989) Spasmodic torticollis due to a midbrain lesions in a case of multiple sclerosis. Movement Disorder 4: 359–362

    Google Scholar 

  22. Podivinsky F (1968) Torticollis. In: Vinken PJ, Bruyn GTW (eds) Handbook of clinical neurology, Vol 6. Diseases of the basal ganglia. North-Holland, Amsterdam, pp 567–603

    Google Scholar 

  23. Riski JE, Horner J, Nashold BS Jr (1990) Swallowing function in patients with spasmodic torticollis. Neurology 40: 1443–1445

    PubMed  Google Scholar 

  24. Shima F, Fukui M, Kitamura K, Kuromatsu C, Okamura T (1988) Diagnosis and surgical treatment of spasmodic torticollis of 11th nerve origin. Neurosurgery 22: 358–363

    PubMed  Google Scholar 

  25. Stell T, Branstein AM, Gresty M, Buckwell D, Marsden CD (1990) Saccadic function in spasmodic torticollis. J Neurol Neurosurg Psychiatry 53: 496–501

    PubMed  Google Scholar 

  26. Stell R, Bronstein AM, Marsden CD (1989) Vestibulo-ocular abnormalities in spasmodic torticollis before and after botulinum toxin injections. J Neurol Neurosurg Psychiatry 52: 57–62

    PubMed  Google Scholar 

  27. Stell R, Gresty M, Metcalfe T, Bronstein AM (1991) Cervicoocular function in patients with spasmodic torticollis. J Neurol Neurosurg Psychiatry 54: 39–41

    PubMed  Google Scholar 

  28. Tarlov E (1970) On the problem of the pathology of spasmodic torticollis in man. J Neurol Neurosurg Psychiatry 33: 457–463

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    H. D. Jho & P. J. Jannetta

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  1. H. D. Jho
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  2. P. J. Jannetta
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Jho, H.D., Jannetta, P.J. Microvascular decompression for spasmodic torticollis. Acta neurochir 134, 21–26 (1995). https://doi.org/10.1007/BF01428497

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