标准三联术加斜角肌离断治疗侧弯型痉挛性斜颈(附25例报道)

Standard triple operation combined with scalenus ablation for the treatment of lateral flexure spasmodic torticollis with 25 cases report

目的探讨侧弯型痉挛性斜颈(ST)的手术治疗。方法华中科技大学同济医学院附属武汉中心医院神经外科自2014年6月至2019年6月收治25例侧弯型ST患者,通过术前肌电图及CT(或MRI)检查判断主要痉挛肌肉,其中23例行标准三联术加斜角肌离断术,2例仅行斜角肌离断,术后6个月评定疗效。结果痊愈17例(68%),显效5例(20%),进步3例(12%),无效0例(0%),无死亡、无致残,无严重并发症。结论标准三联术加行痉挛斜角肌离断是治疗侧弯型ST安全、有效的方法。

Objective To investigate the surgical treatment of lateral flexure spasmodic torticollis(ST).Methods From June 2014 to June 2019,25 patients with lateral flexure ST were treated in the Departments of Neurosurgery,Central Hospital of Wuhan Affiliated to Tongji Medical College,Huazhong University of Science and Technology.Preoperative electromyography and CT(or MRI)examination were used to determine the main spastic muscles.Among them,23 cases of them underwent standard triple operation combined with scalenus ablation,while 2 cases only underwent scalenus ablation surgery.Postoperative efficacy was assessed 6 months after surgery.Results Seventeen cases(68%)were cured,5 cases(20%)were markedly effective,and 3 cases(12%)were improved,0 case(0%)ineffective with no death,no disability and no serious complications.Conclusion Standard triple operation combined with spastic scalenus ablation was a safe and effective method for the treatment of lateral flexure ST.