Microvascular decompression of the accessory nerve for treatment of spasmodic torticollis: early results in 12 cases.

Abstract

To describe the early effectiveness of microvascular decompression (MVD) for the treatment of spasmodic torticollis (ST). Twelve patients with spasmodic torticollis were treated by microvascular decompression of the accessory nerves using a microscopic neurosurgical technique via the retrosigmoid approach. The most common compressing blood vessels were the ipsilateral posterior inferior cerebral artery (PICA) and/or the vertebral artery. The intraoperative monitor was introduced to detect the accessory nerve and to avoid unnecessary damage to the nerve. Ten patients were cured (83%), and the other two (17%) improved with moderate spasms. In most cases, the improvement was noticed 1 week after the operation. No operation-related complications were observed during the follow-up period, which ranged from 2 months to 3 years. The early effect of MVD for some patients with spasmodic torticollis was satisfactory, but the long-term results need to be assessed further.