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Microvascular decompression surgery is effective for the laterocollis subtype of spasmodic torticollis: a long-term follow-up result

  • Clinical Article - Functional
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Abstract

Background

Spasmodic torticollis (ST) is characterized by sustained, involuntary, and painful spasms of specific muscle (s), which results into abnormal posture of the neck and head. Although various treatments for ST have been introduced, none of them shows absolute effectiveness. Earlier research from our department showed that microvascular decompression (MVD) surgery is effective in the short-term for ST patients with confirmed accessory nerve compression. However, the long-term outcome of MVD remains unknown.

Method

Twelve ST patients with confirmed accessory nerve compression received MVD surgery of their accessory nerves. We utilized the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) to evaluate the long-term outcome (5.4 ± 0.87 years).

Results

The MVD lowered total TWSTRS scores by 42.8 % in all ST patients. This result, however, only counted for moderate relief. Interestingly, we observed that the laterocollis (LC) subtypes of ST (n = 3) obtained a higher TWSTRS score improvement (86.9 ± 6.2 %), compared to that of the non-LC (28.1 ± 12 %) (P =0.0001). Additionally, the disability (92.7 ± 2 %) subscale score in the LC subtypes had the most prominent improvement compared to the pain (88.1 ± 5.1 %) and severity (81.3 ± 10.5 %).

Conclusions

In the cases of confirmed accessory nerve compression, the MVD could be considered as a treatment alternative for ST, especially for the LC subtypes.

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Acknowledgment

We thank Prof. Marc Sindou for his comments and encouragement of our report four years ago, inspiring us to improve this work.

Conflicts of Interest

None.

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Authors and Affiliations

  1. Department of Neurosurgery Shanghai Changzheng Hospital, The Second Military Medical University, No 415, Fengyang road, Shanghai, 200003, China

    Qiyong Mei, Ying Jiang, Kehua Sun, Yicheng Lu, Mingxing Sui & Lijun Hou

  2. Department of Clinical Epidemiology and Biostatistics, Peking University People’s Hospital Peking University, Beijing, China

    Chunfang Zhang

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  1. Qiyong Mei
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  2. Chunfang Zhang
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  3. Ying Jiang
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  4. Kehua Sun
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  7. Lijun Hou
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Correspondence to Lijun Hou.

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Qiyong Mei, Chunfang Zhang and Ying Jiang contributed equally to this publication.

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Mei, Q., Zhang, C., Jiang, Y. et al. Microvascular decompression surgery is effective for the laterocollis subtype of spasmodic torticollis: a long-term follow-up result. Acta Neurochir 156, 1551–1556 (2014). https://doi.org/10.1007/s00701-014-2120-y

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