{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:24:49Z","timestamp":1791901489327,"version":"4.3.4"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2003,6]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Selective peripheral denervation is currently the primary surgical treatment for intractable cervical dystonia. The authors assessed preoperative factors to determine which, if any, correlated with outcomes in patients with torticollis who had undergone this procedure.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> The records of 168 consecutive patients who had undergone selective peripheral denervation for cervical dystonia between 1988 and 1996 at the Mayo Clinic were reviewed. There were 89 women (53%) and 79 men (47%) with a mean age of 53.4 years. Selection of muscles for denervation was based on the patient's clinical presentation and electromyography mapping results. The most common torticollis vectors were rotational in 141 patients (84%) and laterocollis in 59 (35%). Seventy patients (42%) presented with combined vectors. The technique used to remedy both conditions involved denervation of the ipsilateral posterior cervical paraspinal and splenius capitis muscles. Denervation of the sternocleidomastoid muscle was performed on the contralateral side for rotational torticollis and on the ipsilateral side for laterocollis. A rigorous physical therapy program followed surgery.<\/jats:p>\n<jats:p content-type=\"fine-print\">At the 3-month postoperative evaluation, 125 patients (77%) of the 162 who were available for follow up had moderate to excellent improvement in their head position, and pain was moderately to markedly improved in 131 patients (81%). The long-term follow up lasted a mean of 3.4 years and was undertaken in 130 patients. The original level of moderate to excellent improvement in head position and pain was retained in at least 71 patients (70%). Outcome was not predicted by preoperative head position, severity of abnormal posture of head, symptom duration, presence of tremor or phasic dystonic movements, or failure to respond to botulinum toxin treatment. Five patients recovered from postoperative complications including one myocardial infarction, one pulmonary embolism, and three respiratory failures. Three patients suffered from persistent C-2 distribution dysesthesias and three from slight shoulder weakness; one had a wound infection, and one died of respiratory arrest.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Selective peripheral denervation is an effective method of achieving lasting improvement of dystonia in most patients with intractable torticollis.<\/jats:p>","DOI":"10.3171\/jns.2003.98.6.1247","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:54:07Z","timestamp":1242237247000},"page":"1247-1254","source":"Crossref","is-referenced-by-count":46,"title":["Selective peripheral denervation for the treatment of intractable spasmodic torticollis: experience with 168 patients at the Mayo Clinic"],"prefix":"10.3171","volume":"98","author":[{"given":"Aaron A.","family":"Cohen-Gadol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Eric","family":"Ahlskog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph Y.","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Swenson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn L.","family":"McClelland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dudley H.","family":"Davis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Appl Neurophysiol","first-page":"319","article-title":"Observations and analysis of results in 131 cases of spasmodic torticollis after selective denervation.","volume":"50","author":"Bertrand","year":"1987"},{"key":"b2","series-title":"Appl Neurophysiol","first-page":"326","article-title":"Technical aspects of selective peripheral denervation for spasmodic torticollis.","volume":"45","author":"Bertrand","year":"1982"},{"key":"b3","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/0090-3019(93)90118-K","article-title":"Selective peripheral denervation for spasmodic torticollis: surgical technique, results, and observations in 260 cases.","volume":"40","author":"Bertrand","year":"1993"},{"key":"b4","series-title":"Adv Neurol","first-page":"637","article-title":"Selective peripheral denervation in 111 cases of spasmodic torticollis: rationale and results.","volume":"50","author":"Bertrand","year":"1988"},{"key":"b5","series-title":"Semin Neurol","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1055\/s-2001-13123","article-title":"The botulinum toxins in the treatment of cervical dystonia.","volume":"21","author":"Brashear","year":"2001"},{"key":"b6","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1227\/00006123-199407000-00009","article-title":"Selective peripheral denervation for the treatment of spasmodic torticollis.","volume":"35","author":"Braun","year":"1994"},{"key":"b7","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1159\/000099562","article-title":"Selective peripheral denervation in patients with spasmodic torticollis.","volume":"57","author":"Braun","year":"1991"},{"key":"b8","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1007\/BF00867420","article-title":"Selective peripheral denervation for spasmodic torticollis: is the outcome predictable?","volume":"242","author":"Braun","year":"1995"},{"key":"b9","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1159\/000048389","article-title":"Selective denervation and resection of cervical muscles in the treatment of spasmodic torticollis: long-term follow-up results in 207 cases.","volume":"75","author":"Chen","year":"2000"},{"key":"b10","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1007\/BF01403205","article-title":"Operative treatment of bilateral retrocollis.","volume":"113","author":"Chen","year":"1991"},{"key":"b11","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/0090-3019(86)90285-5","article-title":"Management of spasmodic torticollis.","volume":"25","author":"Colbassani","year":"1986"},{"key":"b12","series-title":"Neurology","first-page":"A259","article-title":"Specific dystonic factors contributing to work limitation and disability in cervical dystonia.","volume":"46","author":"Comella","year":"1996"},{"key":"b13","series-title":"Arch Surg","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1001\/archsurg.1930.01150120139008","article-title":"An operation for the treatment of spasmodic torticollis.","volume":"20","author":"Dandy","year":"1930"},{"key":"b14","series-title":"Brain","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1093\/brain\/121.4.547","article-title":"Current concepts on the clinical features, aetiology, and management of idiopathic cervical dystonia.","volume":"121","author":"Dauer","year":"1998"},{"key":"b15","series-title":"Mayo Clin Proc","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/S0025-6196(12)60659-4","article-title":"Selective peripheral denervation for torticollis: preliminary results.","volume":"66","author":"Davis","year":"1991"},{"key":"b16","series-title":"Br Foreign Med Chir Rev","first-page":"218","article-title":"Case of excision of a part of the spinal accessory nerve for spasmodic wry neck.","volume":"75","author":"De Morgan","year":"1866"},{"key":"b17","series-title":"J Neurol","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/BF00839204","article-title":"Clinical and polymyographic investigation of spasmodic torticollis.","volume":"239","author":"Deuschl","year":"1992"},{"key":"b18","series-title":"Mayo Clin Proc","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1016\/S0025-6196(12)61592-4","article-title":"Treatment of spasmodic torticollis.","volume":"66","author":"Duane","year":"1991"},{"key":"b19","series-title":"Semin Neurol","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1055\/s-2008-1063861","article-title":"Torsion dystonia: clinical spectrum and treatment.","volume":"2","author":"Fahn","year":"1982"},{"key":"b20","series-title":"Neurol Clin","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1016\/S0733-8619(18)31090-9","article-title":"The varied clinical expressions of dystonia.","volume":"2","author":"Fahn","year":"1984"},{"key":"b21","series-title":"Drugs","doi-asserted-by":"publisher","first-page":"705","DOI":"10.2165\/00003495-200262040-00011","article-title":"Botulinum toxin B: a review of its therapeutic potential in the management of cervical dystonia.","volume":"62","author":"Figgitt","year":"2002"},{"key":"b22","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1136\/jnnp.65.4.472","article-title":"Outcome of selective ramisectomy for botulinum toxin resistant torticollis.","volume":"65","author":"Ford","year":"1998"},{"key":"b23","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"46","DOI":"10.3171\/jns.1993.78.1.0046","article-title":"Treatment of spasmodic torticollis with intradural selective rhizotomies.","volume":"78","author":"Friedman","year":"1993"},{"key":"b24","series-title":"Appl Neurophysiol","first-page":"233","article-title":"Comprehensive management of spasmodic torticollis.","volume":"44","author":"Gildenberg","year":"1981"},{"key":"b25","series-title":"Appl Neurophysiol","first-page":"113","article-title":"Treatment of spasmodic torticollis by dorsal column stimulation.","volume":"41","author":"Gildenberg","year":"1978"},{"key":"b26","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"323","DOI":"10.3171\/jns.1969.31.3.0323","article-title":"Spasmodic torticollis: results after cervical rhizotomy in 50 cases.","volume":"31","author":"Hamby","year":"1969"},{"key":"b27","series-title":"Arch Neurol Psychiatry","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1001\/archneurpsyc.1949.02310090002001","article-title":"Spasmodic torticollis. II. Clinical evaluation.","volume":"61","author":"Herz","year":"1949"},{"key":"b28","series-title":"Arch Neurol","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1001\/archneur.1990.00530050070014","article-title":"Natural history of adult-onset idiopathic torticollis.","volume":"47","author":"Jahanshahi","year":"1990"},{"key":"b29","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1136\/jnnp.65.4.434","article-title":"Re-emergence of surgery for dystonia.","volume":"65","author":"Jankovic","year":"1998"},{"key":"b30","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1212\/WNL.41.7.1088","article-title":"Cervical dystonia: clinical findings and associated movement disorders.","volume":"41","author":"Jankovic","year":"1991"},{"key":"b31","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/BF01428497","article-title":"Microvascular decompression for spasmodic torticollis.","volume":"134","author":"Jho","year":"1995"},{"key":"b32","series-title":"Ann Surg","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1097\/00000658-189101000-00003","article-title":"A new operation for spasmodic wry neck. Namely, division or exsection of the nerves supplying the posterior rotator muscles of the head.","volume":"13","author":"Keen","year":"1891"},{"key":"b33","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"889","DOI":"10.3171\/jns.1999.91.5.0889","article-title":"Partial myotomy\/myectomy of the trapezius muscle with an asleep-awake-asleep anesthetic technique for treatment of cervical dystonia. Technical note.","volume":"91","author":"Krauss","year":"1999"},{"key":"b34","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1136\/jnnp.72.2.249","article-title":"Pallidal deep brain stimulation in patients with cervical dystonia and severe cervical dyskinesias with cervical myelopathy.","volume":"72","author":"Krauss","year":"2002"},{"key":"b35","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1136\/jnnp.63.5.642","article-title":"Symptomatic and functional outcome of surgical treatment of cervical dystonia.","volume":"63","author":"Krauss","year":"1997"},{"key":"b36","series-title":"Clin Neurosurg","first-page":"37","article-title":"The surgical treatment of spasmodic torticollis.","volume":"2","author":"McKenzie","year":"1954"},{"key":"b37","series-title":"Brain","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1093\/brain\/124.4.769","article-title":"Prospective study of selective peripheral denervation for botulinum-toxin resistant patients with cervical dystonia.","volume":"124","author":"Munchau","year":"2001"},{"key":"b38","series-title":"Confin Neurol","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1159\/000103029","article-title":"Long-term results of stereotactic treatment of spasmodic torticollis.","volume":"34","author":"Mundinger","year":"1972"},{"key":"b39","series-title":"Neuron","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1016\/0896-6273(89)90188-8","article-title":"Human gene for torsion dystonia located on chromosome 9q32-q34.","volume":"2","author":"Ozelius","year":"1989"},{"key":"b40","series-title":"Baillieres Clin Neurol","first-page":"179","article-title":"Use of botulinum toxin in the treatment of cervical dystonia.","volume":"2","author":"Poewe","year":"1993"},{"key":"b41","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1227\/00006123-199102000-00016","article-title":"Kenneth McKenzie, Harvey Cushing, and the early neurosurgical treatment of spasmodic torticollis.","volume":"28","author":"Rossitch","year":"1991"},{"key":"b42","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1001\/jama.1965.03090200014003","article-title":"Spasmodic torticollis. Results in 71 surgically treated patients.","volume":"194","author":"Sorensen","year":"1965"},{"key":"b43","series-title":"Muscle Nerve","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1002\/1097-4598(200011)23:11<1752::AID-MUS12>3.0.CO;2-U","article-title":"Utility of an EMG mapping study in treating cervical dystonia.","volume":"23","author":"Van Gerpen","year":"2000"},{"key":"b44","series-title":"Anat Rec","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1002\/ar.1091770402","article-title":"The integrated roles of longus colli and sternocleidomastoid muscles: an electromyographic study.","volume":"177","author":"Vitti","year":"1973"},{"key":"b45","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1227\/00006123-198106000-00008","article-title":"Selective resection and denervation of cervical muscles in the treatment of spasmodic torticollis: results in 60 cases.","volume":"8","author":"Xinkang","year":"1981"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/98\/6\/article-p1247.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/98\/6\/article-p1247.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/98\/6\/article-p1247.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T20:02:06Z","timestamp":1679860926000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/98\/6\/article-p1247.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,6]]},"references-count":45,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/jns.2003.98.6.1247","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[2003,6]]}}}