{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:19:19Z","timestamp":1761823159998},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,9]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Botulinum toxin injections are the best therapeutic option in patients with spasmodic torticollis. Although a small number of patients do not benefit from such therapy, the majority respond well but may develop antibodies to the toxin after repeated applications. In those termed primary nonresponders, no improvement related to botulinum toxin has been shown. In patients in whom no response was shown and those in whom resistance to the therapy developed, selective peripheral denervation is a neurosurgical option.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Between June 1988 and August 2001, 155 patients underwent selective peripheral denervation. Surgery was performed at a mean of 8.5 years after the onset of symptoms (range 0.5\u201337 years). The mean age of the patients at the onset of dystonia was 39.7 years (range 17\u201377 years). For evaluation of results, patients' responses were assessed. Results were obtained in 140 patients in whom the follow-up period ranged from 3 to 124 months (mean 32.8 months): 18 reported complete relief of their symptoms, 50 significant relief, and 34 moderate relief; 19 noted only minor relief and the remaining 19 no improvement. The results differ substantially when compared with those previously demonstrated in patients who received botulinum toxin injections. Although 80% of the secondary nonresponders were satisfied with the result of surgery, only 62% of the primary nonresponders considered the operation helpful. There were no major side effects. The recurrence rate was 11%.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> The injection of botulinum toxin should be the first-choice treatment. If surgery is required, selective peripheral denervation provides the best results and has the fewest side effects compared with all surgical options.<\/jats:p>","DOI":"10.3171\/spi.2002.97.2.0207","type":"journal-article","created":{"date-parts":[[2009,5,7]],"date-time":"2009-05-07T15:52:47Z","timestamp":1241711567000},"page":"207-212","source":"Crossref","is-referenced-by-count":12,"title":["Selective peripheral denervation for spasmodic torticollis: 13-year experience with 155 patients"],"prefix":"10.3171","volume":"97","author":[{"given":"Veit","family":"Braun","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Peter","family":"Richter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1007\/BF01401830","article-title":"Microneural decompression operations in the treatment of some forms of cranial rhizopathy.","volume":"125","author":"Aksik","year":"1993"},{"key":"b2","series-title":"Mov Disord","first-page":"128","article-title":"Selective peripheral denervation: a surgical alternative in the treatment for spasmodic torticollis. 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Namely, division or exsection of the nerves supplying the posterior rotator muscles of the head.","volume":"13","author":"Keen","year":"1891"},{"key":"b17","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1016\/S0140-6736(99)80022-1","article-title":"Bilateral stimulation of globus pallidus internus for treatment of cervical dystonia.","volume":"354","author":"Krauss","year":"1999"},{"key":"b18","series-title":"Nervenarzt","first-page":"420","article-title":"Zur psychoanalyse des torticollis spasticus.","volume":"42","author":"Mitscherlich","year":"1971"},{"key":"b19","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":"b20","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1212\/WNL.16.9.867","article-title":"Spasmodic torticollis. 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