Stereotactic and functional neurosurgery · 2003
A novel denervation procedure for idiopathic cervical dystonia.
Клиническое исследованиеКонтролируемое клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Taira Takaomi, Hori Tomokatsu
Аннотация
BACKGROUND: For idiopathic cervical dystonia, the treatment of choice is botulinum toxin injection or surgical denervation. There are two major procedures of surgical denervation: intradural ventral rhizotomy and extradural peripheral neurotomy (Bertrand procedure). The Bertrand procedure is always accompanied by popstoperative sensory loss in the C2 region.
METHODS: The authors have modified these procedures to minimize the complications. Our method is unilateral intradural ventral rhizotomy of C1 and C2, extradural denervation of the C3-C6 posterior rami and contralateral peripheral sectioning of the branches of the accessory nerve to the sternocleidomastoid muscle. Forty-four patients underwent this modified operation ('Taira's' method: group A) and the results were compared with those in a matched control group of 38 patients who underwent the traditional Bertrand's procedure (Bertrand's method: group B).
RESULTS: Three patients in group A showed a sensory deficit in the C2 area, while all of the patients in group B had C2 sensory disturbance. Pre- and postoperative rating scores did not differ between the two groups. The intraoperative blood loss was significantly smaller in group A.
CONCLUSION: Compared with the traditional Bertrand's operation, our procedure carries a much lower incidence of complications and a significant decrease of intraoperative blood loss.
METHODS: The authors have modified these procedures to minimize the complications. Our method is unilateral intradural ventral rhizotomy of C1 and C2, extradural denervation of the C3-C6 posterior rami and contralateral peripheral sectioning of the branches of the accessory nerve to the sternocleidomastoid muscle. Forty-four patients underwent this modified operation ('Taira's' method: group A) and the results were compared with those in a matched control group of 38 patients who underwent the traditional Bertrand's procedure (Bertrand's method: group B).
RESULTS: Three patients in group A showed a sensory deficit in the C2 area, while all of the patients in group B had C2 sensory disturbance. Pre- and postoperative rating scores did not differ between the two groups. The intraoperative blood loss was significantly smaller in group A.
CONCLUSION: Compared with the traditional Bertrand's operation, our procedure carries a much lower incidence of complications and a significant decrease of intraoperative blood loss.