Selective peripheral denervation for spasmodic torticollis: surgical technique, results, and observations in 260 cases

Abstract

A total of 260 cases of spasmodic torticollis or of the cervical component of diffuse dystonias have been surgically treated with selective peripheral denervation of the involved muscles sparing their antagonists, after verification with electromyography and, if necessary, nerve blocks. Total or marked relief of symptoms with preservation of normal or nearly normal movements has been obtained in 88% of the patients with surgery followed by early physiotherapy. There are minimal sequelae with this approach. Selective denervation may be recommended if, after 2 years, conservative treatment, including botulinum injections, does not offer satisfactory relief of symptoms.