旋转型痉挛性斜颈的手术治疗

目的 研究旋转型痉挛性斜颈（rotational spasmodic torticollis，RoST）的临床分型和手术治疗。方法对RoST按痉挛肌肉范围，姿态，肌肉痉挛的方式，病情程度分型。手术治疗：采用下列术式或二至三种术式组合。术式一：面部旋向侧颈后痉挛肌肉选择性切除术。术式二：同侧颈神经1-6（C1-8）后支选择性切断术。术式三：对侧副神经切断术（或加胸锁乳突肌切除术）。结果术后6个月评定疗效，全组423例，斜颈症状消失292例（69％），显效78例（18．4％），进步42例（10％），无效11例（2．6％）。无死亡，无并发症。结论采用颈部痉挛肌肉和神经选择性切断术治疗RoST创伤小、操作简便，安全无残疾。

Surgical treatment of rotational spasmodic torticollis

Objective To study surgical treatment of rotational spasmodic torticollis (RoST). Methods The classification according to the pose of RoST. Rotational ST (ROST); according to the range of spasmodic muscles: primary ST and symptomatic ST; according to the mode of the spasmodic muscles: stiffness ST and clonus ST: according to the extent of symptoms: slight ST and serious ST. Surgical treatment: The operative mode was depended on the pose of ST. The model ,2,3 or their combination. Mode 1: Selective resection of posterior cervical spasmodic muscles. Mode 2: Selective neurotomy of posterior branches of cervical nerve 1 6. Mode 3: Comtialatearal accessory neurotomy. Rusults The evaluation of clinical effects over 6 months postoperation showed 292 were recovered ( 69 % ), 78 markly effective ( 18. 4 % ), 42 progress ( 10% ), 11 inefficiency (2. 6%) and no dead. Conclusion The surgical treatment of selective resection of cervical spasmodic muscles and selective neurotomv of cervical nerve for ST is safe and effective.