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Neck Operative Treatment of Spasmodic Torticollis

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OPERATIVE TREATMENT OF SPASMODIC TORTICOLLIS, NECK.

A case of a woman, fifty six years of age, who for a period of three years had been the vic tim of spasmodic torticollis. Pressure at the point of entrance of the spinal accessory of the right side into the sternomastoid muscle caused a temporary cessation of the convulsive move ments. Six centimetres of this nerve were removed. While im provement followed the operation, the effect was not curative. Accordingly, one year later a resection was made of the first, second, and third cervical nerves as well as of the obliquus infe rior. The result was entirely satisfactory. Freedom from con vulsive movements gradually took place, and up to the time of this report, a period of three years, there has been no recurrence.

The idea of resecting the first three cervical nerves first ema nated from the English surgeons. Kocher recommended section of the muscle. The author finds in the literature reports of fifteen cases of resection of the cervical nerves with eleven cures and four improvements ; twelve cases of section of the muscle with seven cures, three improvements, and two failures; sixty-eight cases of resection of the spinal accessory with only twenty-three complete cures. The author points to the necessity of employing resection of the first three cervical nerves in those cases in which resection of the spinal accessory meets with failure. Prager medicinische Wochenschrift, No. 2, 1900.

resection and nerves