Spasmodic torticollis. Results in 71 surgically treated patients

Abstract

Seventy-one patients, 43 men and 28 women, with spasmodic torticollis were treated surgically over an 18-year period. The average age at onset of symptoms was 43.2 years. No evidence was found to suggest a psychological origin of spasmodic torticollis. The etiology is organically based although the exact mechanism is not known. Conservative therapy benefited only 5 of the 66 patients preoperatively. The final objective results for the 70 surviving patients were as follows no improvement in 4, minimal improvement in 7, moderate improvement in 22, and excellent improvement in 37. Anterior cervical rhizotomy and subarachnoid spinal accessory neurectomy should be the initial operation for spasmodic torticollis and if further surgical therapy is required, peripheral spinal accessory neurectomy is indicated. The findings in our series indicate that operation should be the primary treatment for spasmodic torticollis.