Spasmodic Torticollis (Cervical Dystonia), CCND Winnipeg
RHIZOTOMY PROCEDURES FOR ST
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     Destructive procedures for ST aim to interrupt the neural pathways thought to be responsible for the neck spasms. Some believe that hyperactivity of the basal ganglia cause Spasmodic Torticollis (ST), and therefore focus injuries upon the thalamus (thalamotomy) or globus pallidus (pallidotomy). Alternatively, surgical attention may be directed at the individual muscles, either by severing or removing them, (myotomy) or cutting their nerve supply. The nerve injury procedures include rhizotomies of the upper anterior nerve roots or accessory nerve rootlets, as well as selective peripheral denervation. This latter procedure aims to only interrupt nerve branches to affected neck muscles, while preserving normal muscle activity.

     These procedures have shown moderate to very good success rates, but ST patients usually only resort to them when their symptoms have become severe and unresponsive to other therapies. This is because of the invasive and permanent nature of these destructive procedures. Risks of potential complications must also be considered, including the loss of muscle control, muscle atrophy and neck deformity, instability, the continued presence of pain, and the possible spread of ST to different muscles.

     Unfortunately, no treatment approach is effective for all patients with ST. Therefore, careful consultation with experienced neurologists and neurosurgeons is important in formulating a management plan.

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Prepared by A. M. Kaufmann, M. Patel & C. Campbell
© 2001 Centre for Cranial Nerve Disorders, Winnipeg, University of Manitoba, Health Sciences Centre. The information provided on this web-site is intended for educational purposes only, and should not be used to diagnose or treat a disease or disorder. This information is not intended to substitute, supplement, or in any way qualify the services or advice provided by a qualified health care professional. Please consult with a certified health care professional before pursuing any form of medical action. Duplication in any part or form of this document is strictly prohibited. All rights reserved. For further information please read our disclaimer. Web-Site related inquiries can be directed to the Information Provider.