痙性斜頸の外科治療と遠隔成績

概要

論文の詳細を見る
The long-term results of 15 cases of spasmodic torticollis who had undergone different surgeries since January 1967 were studied. There were nine males and six females with an average age at surgery of 38.9 years. They included seven cases of the rotatory type, five cases of antecollis, and three cases of retrocollis. Electromyographic (EMG) abnormalities, which decided the surgical method and extent, were elicited in all cases. Thirteen cases underwent bilateral section of the C1 through C3 anterior roots (with or without unilateral C4) and spinal roots of the accessory nerves. Myotomies of the sternocleidomastoid muscle, the trapezius muscle, etc. were performed five times for four cases, and bilateral stereotactic thalamotomy was done in one case. Another case underwent neurovascular lysis of the bilateral spinal accessory nerves with excellent result, although its follow-up period has been only 7 months. The follow-up period ranged between 15 years 5 months and 7 months (6 years 5 months average). The early results were excellent in three cases, good in six, and fair in six. The long-term assessment found excellent condition in only one case, good in three, fair in seven, unchanged in three, and worse in one. These later results were worse, indicating deterioration of symptoms with time. Postoperative EMG gave some information about outcome. The cases with cervical spondylosis had worse results than did those without. The cases of retrocollis showed the worst results. Unilateral section of the anterior C4 root caused no practical respiratory disturbance. The conventional surgeries for spasmodic torticollis improved the symptoms, but were not totally satisfactory to the patients. On the other hand, the recently introduced method of neurovascular lysis preserved the physiological functions and might elucidate the etiology of spasmodic torticollis.
1983-09-15

痙性斜頸の外科治療と遠隔成績

スポンサーリンク

概要

著者

関連論文

スポンサーリンク