Selective Resection and Denervation of Cervical Muscles in the Treatment of Spasmodic Torticollis

Abstract

The author presents a series of 60 patients with torticollis who were treated successfully by operation. He describes the clinical types of torticollis: rotational torticollis, retrocollis, antecollis, lateroflexional torticollis, and combined types. The muscular mechanism of torticollis is detailed, and the operative technique of resecting or denervating only the principal or motive muscles is explained and illustrated for each type of torticollis. The results in this series were very good: 83.3% recovered completely or were improved markedly, and there were no complications.

Co-activation of Sternocleidomastoid Muscles During Maximum Clenching

“…It is innervated by cervical segments of the spinal accessory nerve (XI) and by the cervical segments (C2, C3, and C4) directly. It has been implicated in various clinical pathologies, including headache (Braafand Rosner, 1975;Edeling, 1982), vertigo (Ryan and Cope, 1955;Travell, 1955;Weeks and Travell, 1955;Jongkees, 1969), torticollis (Xinkang, 1981;Goor, 1984;Webb, 1987), and myofascial pain dysfunction (Butler et al, 1975;Curtis, 1980). The purpose of this study was to quantify the level of EMG activity ofthe SCM during maximum jaw clenching by healthy subjects and to relate this level to that achieved during maximum voluntary activity of the SCM.…”