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Unilateral pallidotomy in the treatment of cervical dystonia: a retrospective observational study
- Source :
- Journal of Neurosurgery. 134:216-222
- Publication Year :
- 2021
- Publisher :
- Journal of Neurosurgery Publishing Group (JNSPG), 2021.
-
Abstract
- OBJECTIVEThe objective of this study was to assess the efficacy of unilateral pallidotomy in patients with asymmetrical cervical dystonia.METHODSThis study retrospectively included 25 consecutive patients with asymmetrical cervical dystonia refractory to botulinum toxin injections, who underwent unilateral pallidotomy between January 2015 and April 2017. Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) scores were evaluated preoperatively and 1 week, 3 months, and 6 months postoperatively. The clinical responses were defined as good responders, exhibiting > 50% improvement in the TWSTRS score at 6 months postsurgery, or poor responders, exhibiting < 50% improvement in TWSTRS scores at 6 months postsurgery.RESULTSTwelve and 9 patients showed right- and left-side rotation, respectively; 1 and 3 patients had right- and left-side laterocollis, respectively. The mean age of onset and duration of the disease were 40.2 ± 13.9 and 8.9 ± 10.9 years, respectively. Mean TWSTRS scores were 38.4 ± 12.6 (p < 0.001), 17.3 ± 12.4 (p < 0.001), 19.5 ± 13.4 (p < 0.001), and 20.0 ± 14.7 (p < 0.001), preoperatively and 1 week, 3 months, and 6 months postoperatively, respectively. Fourteen patients (56%) demonstrated > 50% improvement in their TWSTRS total score (mean improvement of TWSTRS total score = 70.5%) 6 months postsurgically. Furthermore, preoperative TWSTRS severity score was a prognostic factor (odds ratio 1.37, 95% confidence interval 1.06–1.78, p = 0.003).CONCLUSIONSThese results suggest that unilateral pallidotomy is an acceptable treatment option for asymmetrical cervical dystonia. Further investigations with a larger number of cases and longer follow-up period are required to confirm these data.
- Subjects :
- medicine.medical_specialty
business.industry
medicine.medical_treatment
Retrospective cohort study
Spasmodic Torticollis
General Medicine
Odds ratio
medicine.disease
Botulinum toxin
Confidence interval
Surgery
03 medical and health sciences
0302 clinical medicine
Refractory
030220 oncology & carcinogenesis
Medicine
Pallidotomy
Cervical dystonia
business
030217 neurology & neurosurgery
medicine.drug
Subjects
Details
- ISSN :
- 19330693 and 00223085
- Volume :
- 134
- Database :
- OpenAIRE
- Journal :
- Journal of Neurosurgery
- Accession number :
- edsair.doi.dedup.....1830d394f7bb718bce809369a3ff3785