{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T08:16:00Z","timestamp":1770452160409,"version":"3.49.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"11","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,3,17]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Degenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction. Tourette syndrome (TS) represents a rare cause of DCM that is incompletely characterized in the literature. Patients with TS might develop repetitive involuntary cervical movements that can accelerate spondylotic changes. Therefore, patients with myelopathy secondary to TS or other tic disorders might exhibit DCM symptoms at younger ages. The present study examines the surgical management of DCM secondary to TS in the literature and describes the outcomes of 3 patients who were treated for DCM secondary to TS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>In these 3 described cases, fractures led to DCM in 2 patients, while cervical spondylosis led to DCM in 1 patient, all associated with TS. Treating motor tics with medications or deep brain stimulation (DBS) provided effective tic management. All 3 patients experienced improvements in their neurological symptoms following surgery, consistent with other reports in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>When treating patients with cervical myelopathy secondary to TS, the authors recommend prioritizing motor tic management prior to considering secondary interventions such as surgery. According to the authors, treating motor tics with medications or DBS provides effective tic management. This approach allows for an uncomplicated postoperative course and satisfactory relief of cervical myelopathy.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24751\">https:\/\/thejns.org\/doi\/10.3171\/CASE24751<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24751","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T03:01:43Z","timestamp":1742180503000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical management of tic-induced myelopathy and the importance of perioperative tic control: illustrative cases"],"prefix":"10.3171","volume":"9","author":[{"given":"Andrew D.","family":"Pumford","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5237-3015","authenticated-orcid":true,"given":"Hannah A.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryder R.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachariah W.","family":"Pinter","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy L.","family":"Fogelson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin D.","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin D.","family":"Helgeson","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brett A.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arjun S.","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Spine J","first-page":"190S","article-title":"Pathophysiology of cervical myelopathy","volume":"6","author":"Baptiste","year":"2006","unstructured":"Baptiste DCFehlings MG.Pathophysiology of cervical myelopathy. Spine J. 2006;6(6suppl):190S-197S."},{"issue":"5","key":"bib2","series-title":"Mov Disord","first-page":"563","article-title":"Severe motor tics causing cervical myelopathy in Tourette\u2019s syndrome","volume":"11","author":"Krauss","year":"1996","unstructured":"Krauss JKJankovic J.Severe motor tics causing cervical myelopathy in Tourette\u2019s syndrome. Mov Disord. 1996;11(5):563-566."},{"issue":"3-4","key":"bib3","series-title":"Childs Nerv Syst","first-page":"191","article-title":"Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord","volume":"18","author":"Muroi","year":"2002","unstructured":"Muroi AMatsumura AAsakawa HEnomoto TIwasaki NNose T.Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord. Childs Nerv Syst. 2002;18(3-4):191-194."},{"issue":"2","key":"bib4","series-title":"Korean J Neurotrauma","first-page":"199","article-title":"Progressive cervical spondylotic myelopathy caused by tic disorders in a young adult with Tourette syndrome","volume":"15","author":"Kim","year":"2019","unstructured":"Kim JKim JYLee JMProgressive cervical spondylotic myelopathy caused by tic disorders in a young adult with Tourette syndrome. Korean J Neurotrauma. 2019;15(2):199-203."},{"issue":"5","key":"bib5","series-title":"Parkinsonism Relat Disord","first-page":"443","article-title":"Efficacy of botulinum toxin in severe Tourette syndrome with dystonic tics involving the neck","volume":"14","author":"Aguirregomozcorta","year":"2008","unstructured":"Aguirregomozcorta MPagonabarraga JDiaz-Manera JPascual-Sedano BGironell AKulisevsky J.Efficacy of botulinum toxin in severe Tourette syndrome with dystonic tics involving the neck. Parkinsonism Relat Disord. 2008;14(5):443-445."},{"issue":"4","key":"bib6","series-title":"Mov Disord","first-page":"452","article-title":"Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation","volume":"29","author":"Huasen","year":"2014","unstructured":"Huasen BMcCreary REvans JPotter GSilverdale M.Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation. Mov Disord. 2014;29(4):452-453."},{"issue":"2","key":"bib7","series-title":"Childs Nerv Syst","first-page":"317","article-title":"Cervical spondylotic myelopathy caused by violent motor tics in a child with Tourette syndrome","volume":"29","author":"Ko","year":"2013","unstructured":"Ko DYKim SKChae JHWang KCPhi JH.Cervical spondylotic myelopathy caused by violent motor tics in a child with Tourette syndrome. Childs Nerv Syst. 2013;29(2):317-321."},{"issue":"2","key":"bib8","series-title":"Nat Rev Neurol","first-page":"108","article-title":"Degenerative cervical myelopathy\u2014update and future directions","volume":"16","author":"Badhiwala","year":"2020","unstructured":"Badhiwala JHAhuja CSAkbar MADegenerative cervical myelopathy\u2014update and future directions. Nat Rev Neurol. 2020;16(2):108-124."},{"issue":"4","key":"bib9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"334","article-title":"Pathogenesis of cervical spondylotic myelopathy","volume":"62","author":"Levine","year":"1997","unstructured":"Levine DN.Pathogenesis of cervical spondylotic myelopathy. J Neurol Neurosurg Psychiatry. 1997;62(4):334-340."},{"issue":"8","key":"bib10","series-title":"Neurology","first-page":"697","article-title":"Noncompressive myelopathy associated with violent axial tics of Tourette syndrome","volume":"74","author":"Isaacs","year":"2010","unstructured":"Isaacs JDAdams MLees AJ.Noncompressive myelopathy associated with violent axial tics of Tourette syndrome. Neurology. 2010;74(8):697-698."},{"key":"bib11","series-title":"Pediatr Neurol","first-page":"99","article-title":"Severe neurological complications associated with Tourette syndrome","volume":"61","author":"Patterson","year":"2016","unstructured":"Patterson ALChoudhri AFIgarashi MMcVicar KShah NMorgan R.Severe neurological complications associated with Tourette syndrome. Pediatr Neurol. 2016;61:99-106."},{"issue":"2","key":"bib12","series-title":"Brain Dev","first-page":"61","article-title":"Tourette\u2019s syndrome with cervical disc herniation","volume":"29","author":"Lin","year":"2007","unstructured":"Lin JJWang HSWong MCWu CTLin KL.Tourette\u2019s syndrome with cervical disc herniation. Brain Dev. 2007;29(2):61-63."},{"issue":"11","key":"bib13","series-title":"Neurology","first-page":"1862","article-title":"Cervical myelopathy secondary to violent tics of Tourette\u2019s syndrome","volume":"60","author":"Dobbs","year":"2003","unstructured":"Dobbs MBerger JR.Cervical myelopathy secondary to violent tics of Tourette\u2019s syndrome. Neurology. 2003;60(11):1862-1863."},{"issue":"4","key":"bib14","series-title":"Ann Neurol","article-title":"Gilles de la Tourette syndrome and compressive neuropathies","volume":"8","author":"Goetz","year":"1980","unstructured":"Goetz CGKlawans HL.Gilles de la Tourette syndrome and compressive neuropathies. Ann Neurol. 1980;8(4):453."},{"issue":"3","key":"bib15","series-title":"Ann Neurol","article-title":"Cervical disc herniation in the Gilles de la Tourette syndrome","volume":"9","author":"Brill","year":"1981","unstructured":"Brill CBHartz WHMancall EL.Cervical disc herniation in the Gilles de la Tourette syndrome. Ann Neurol. 1981;9(3):311."},{"issue":"2","key":"bib16","series-title":"Rinsho Shinkeigaku","first-page":"177","article-title":"Flexion myelopathy due to tic of neck","volume":"29","author":"Nomura","year":"1989","unstructured":"Nomura TKira JYoshimura TGoto IHasuo K.Flexion myelopathy due to tic of neck. Article in Japanese. Rinsho Shinkeigaku. 1989;29(2):177-179."},{"issue":"1","key":"bib17","series-title":"Mov Disord","first-page":"79","article-title":"Perioperative use of botulinum toxin for movement disorder-induced cervical spine disease","volume":"11","author":"Adler","year":"1996","unstructured":"Adler CHZimmerman RSLyons MKSimeone FBrin MF.Perioperative use of botulinum toxin for movement disorder-induced cervical spine disease. Mov Disord. 1996;11(1):79-81."},{"issue":"suppl","key":"bib18","series-title":"J Spinal Disord Tech","first-page":"S107","article-title":"Surgical treatment of cervical myeloradiculopathy associated with movement disorders: indications, technique, and clinical outcome","volume":"18","author":"Wong","year":"2005","unstructured":"Wong ASMassicotte EMFehlings MG.Surgical treatment of cervical myeloradiculopathy associated with movement disorders: indications, technique, and clinical outcome. J Spinal Disord Tech. 2005;18(suppl):S107-S114."},{"issue":"6","key":"bib1","series-title":"Spine J","first-page":"190S","article-title":"Pathophysiology of cervical myelopathy","volume":"6","author":"Baptiste","year":"2006","unstructured":"Baptiste DCFehlings MG.Pathophysiology of cervical myelopathy. Spine J. 2006;6(6suppl):190S-197S."},{"issue":"5","key":"bib2","series-title":"Mov Disord","first-page":"563","article-title":"Severe motor tics causing cervical myelopathy in Tourette\u2019s syndrome","volume":"11","author":"Krauss","year":"1996","unstructured":"Krauss JKJankovic J.Severe motor tics causing cervical myelopathy in Tourette\u2019s syndrome. Mov Disord. 1996;11(5):563-566."},{"issue":"3-4","key":"bib3","series-title":"Childs Nerv Syst","first-page":"191","article-title":"Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord","volume":"18","author":"Muroi","year":"2002","unstructured":"Muroi AMatsumura AAsakawa HEnomoto TIwasaki NNose T.Myelopathy caused by tics in an adolescent, associated with T2 signal intensity changes of the spinal cord. Childs Nerv Syst. 2002;18(3-4):191-194."},{"issue":"2","key":"bib4","series-title":"Korean J Neurotrauma","first-page":"199","article-title":"Progressive cervical spondylotic myelopathy caused by tic disorders in a young adult with Tourette syndrome","volume":"15","author":"Kim","year":"2019","unstructured":"Kim JKim JYLee JMProgressive cervical spondylotic myelopathy caused by tic disorders in a young adult with Tourette syndrome. Korean J Neurotrauma. 2019;15(2):199-203."},{"issue":"5","key":"bib5","series-title":"Parkinsonism Relat Disord","first-page":"443","article-title":"Efficacy of botulinum toxin in severe Tourette syndrome with dystonic tics involving the neck","volume":"14","author":"Aguirregomozcorta","year":"2008","unstructured":"Aguirregomozcorta MPagonabarraga JDiaz-Manera JPascual-Sedano BGironell AKulisevsky J.Efficacy of botulinum toxin in severe Tourette syndrome with dystonic tics involving the neck. Parkinsonism Relat Disord. 2008;14(5):443-445."},{"issue":"4","key":"bib6","series-title":"Mov Disord","first-page":"452","article-title":"Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation","volume":"29","author":"Huasen","year":"2014","unstructured":"Huasen BMcCreary REvans JPotter GSilverdale M.Cervical myelopathy secondary to Tourette's syndrome managed by urgent deep brain stimulation. Mov Disord. 2014;29(4):452-453."},{"issue":"2","key":"bib7","series-title":"Childs Nerv Syst","first-page":"317","article-title":"Cervical spondylotic myelopathy caused by violent motor tics in a child with Tourette syndrome","volume":"29","author":"Ko","year":"2013","unstructured":"Ko DYKim SKChae JHWang KCPhi JH.Cervical spondylotic myelopathy caused by violent motor tics in a child with Tourette syndrome. Childs Nerv Syst. 2013;29(2):317-321."},{"issue":"2","key":"bib8","series-title":"Nat Rev Neurol","first-page":"108","article-title":"Degenerative cervical myelopathy\u2014update and future directions","volume":"16","author":"Badhiwala","year":"2020","unstructured":"Badhiwala JHAhuja CSAkbar MADegenerative cervical myelopathy\u2014update and future directions. Nat Rev Neurol. 2020;16(2):108-124."},{"issue":"4","key":"bib9","series-title":"J Neurol Neurosurg Psychiatry","first-page":"334","article-title":"Pathogenesis of cervical spondylotic myelopathy","volume":"62","author":"Levine","year":"1997","unstructured":"Levine DN.Pathogenesis of cervical spondylotic myelopathy. J Neurol Neurosurg Psychiatry. 1997;62(4):334-340."},{"issue":"8","key":"bib10","series-title":"Neurology","first-page":"697","article-title":"Noncompressive myelopathy associated with violent axial tics of Tourette syndrome","volume":"74","author":"Isaacs","year":"2010","unstructured":"Isaacs JDAdams MLees AJ.Noncompressive myelopathy associated with violent axial tics of Tourette syndrome. Neurology. 2010;74(8):697-698."},{"key":"bib11","series-title":"Pediatr Neurol","first-page":"99","article-title":"Severe neurological complications associated with Tourette syndrome","volume":"61","author":"Patterson","year":"2016","unstructured":"Patterson ALChoudhri AFIgarashi MMcVicar KShah NMorgan R.Severe neurological complications associated with Tourette syndrome. Pediatr Neurol. 2016;61:99-106."},{"issue":"2","key":"bib12","series-title":"Brain Dev","first-page":"61","article-title":"Tourette\u2019s syndrome with cervical disc herniation","volume":"29","author":"Lin","year":"2007","unstructured":"Lin JJWang HSWong MCWu CTLin KL.Tourette\u2019s syndrome with cervical disc herniation. Brain Dev. 2007;29(2):61-63."},{"issue":"11","key":"bib13","series-title":"Neurology","first-page":"1862","article-title":"Cervical myelopathy secondary to violent tics of Tourette\u2019s syndrome","volume":"60","author":"Dobbs","year":"2003","unstructured":"Dobbs MBerger JR.Cervical myelopathy secondary to violent tics of Tourette\u2019s syndrome. Neurology. 2003;60(11):1862-1863."},{"issue":"4","key":"bib14","series-title":"Ann Neurol","article-title":"Gilles de la Tourette syndrome and compressive neuropathies","volume":"8","author":"Goetz","year":"1980","unstructured":"Goetz CGKlawans HL.Gilles de la Tourette syndrome and compressive neuropathies. Ann Neurol. 1980;8(4):453."},{"issue":"3","key":"bib15","series-title":"Ann Neurol","article-title":"Cervical disc herniation in the Gilles de la Tourette syndrome","volume":"9","author":"Brill","year":"1981","unstructured":"Brill CBHartz WHMancall EL.Cervical disc herniation in the Gilles de la Tourette syndrome. Ann Neurol. 1981;9(3):311."},{"issue":"2","key":"bib16","series-title":"Rinsho Shinkeigaku","first-page":"177","article-title":"Flexion myelopathy due to tic of neck","volume":"29","author":"Nomura","year":"1989","unstructured":"Nomura TKira JYoshimura TGoto IHasuo K.Flexion myelopathy due to tic of neck. Article in Japanese. Rinsho Shinkeigaku. 1989;29(2):177-179."},{"issue":"1","key":"bib17","series-title":"Mov Disord","first-page":"79","article-title":"Perioperative use of botulinum toxin for movement disorder-induced cervical spine disease","volume":"11","author":"Adler","year":"1996","unstructured":"Adler CHZimmerman RSLyons MKSimeone FBrin MF.Perioperative use of botulinum toxin for movement disorder-induced cervical spine disease. Mov Disord. 1996;11(1):79-81."},{"issue":"suppl","key":"bib18","series-title":"J Spinal Disord Tech","first-page":"S107","article-title":"Surgical treatment of cervical myeloradiculopathy associated with movement disorders: indications, technique, and clinical outcome","volume":"18","author":"Wong","year":"2005","unstructured":"Wong ASMassicotte EMFehlings MG.Surgical treatment of cervical myeloradiculopathy associated with movement disorders: indications, technique, and clinical outcome. 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