选择性周围神经切断和肌切断治疗痉挛性斜颈400例结果

目的 分析400例选择性周围神经切断和肌切断术治疗痉挛性斜颈的方法和效果。方法 借助肌电图(EMG)，CT或MRI等检查揭示参加痉挛的肌群。作者将痉挛肌分为三类，原动肌作去神经术和肌切断术，协同肌作去神经术，随从肌可不予处理。文中介绍三种临床型别的手术入路。结果 手术共400例，其中272例经2～31年长期随访，总优良率为86．4％，无死亡，无重大并发症，颈向各方向运动有力，疗效最长的患者至今已31年。结论 本手术方法适用于姑息治疗无效的痉挛性斜颈病例。

Selective peripheral denervation and myotomy for spasmodic torticollis, with results of 400 cases

Objective To analyse the outcome of patients with selective denervations and resection of cervical muscles for spasmodic torticollis. Methods The spasmodic muscles were identified by EMG, CT or MRI preoperatively.The involved muscles of neck might be divided into three groups: Agonist, Synergist and subsynergist, of which the operative methods are different:peripheral denervation plus muscle resection for agonist; denervation only for the synergist and nothing to be done for the subsynergist. According to its clinical types of torticollis (rotational,lateral-flexional and retrocollis),the paper present three different surgical methods. Results Total or remarked relief of symptoms with preservation of normal or nearly normal movements has been obtained in 86.4% after a long-term(2~31 years)follow up. There was no death, no major complication in this series. Conclusion This procedure may be recommended if one year of conservative therapy does not offer satisfactory relief of symptom.