Cervical dystonia induced by cervical spine surgery: a case report.
METHODS
A case report.


OBJECTIVE
To describe an interesting patient who underwent a three-level corpectomy of the cervical spine complicated by cervical dystonia and eventually treated successfully with botulinum toxin injections.


BACKGROUND
Cervical dystonia is a relatively rare disease and unfamiliar to many clinicians. Various types of peripheral trauma or peripheral lesion have been reported to induce cervical dystonia. However, to the best of our knowledge, there have been no reports about cervical dystonia following cervical spine surgery.


METHODS
We present a case of a 45-year-old man who developed severe axial neck pain after cervical anterior corpectomy and fibula strut grafting due to cervical myelopathy. His neck pain gradually worsened, and involuntary spasmodic neck movement developed 6 weeks after operation when his halo-vest was removed. Initially, we considered his complaint to be transient or psychogenic, and diagnosis of cervical dystonia was delayed until 14 weeks after operation.


RESULTS
Pharmacologic treatment was unsuccessful, but he was successfully treated with local intramuscular injections of botulinum toxin.


CONCLUSIONS
It must be kept in mind that cervical spine surgery is not an exceptional precipitator of cervical dystonia, despite the fact that it is extremely rare.
Takemoto
Mitsuru
M
Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. m.take@kuhp.kyoto-u.ac.jp
Ikenaga
Minoru
M
Tanaka
Chiaki
C
Sonobe
Masanobu
M
Shikata
Jitsuhiko
J
D018726:Anti-Dyskinesia Agents / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications; D013117:Spinal Cord Compression / Q000209:etiology* / Q000503:physiopathology; D013123:Spinal Fusion / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D014103:Torticollis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome
D018726:Anti-Dyskinesia Agents; D001905:Botulinum Toxins