title: Selective peripheral denervation for the treatment of spasmodic torticollis: long-term follow-up results from 648 patients.
abstract: BACKGROUND
  Selective peripheral denervation (SPD) is currently the primary surgical treatment for spasmodic torticollis (ST). Our objective here is to report on the outcome of patients treated with this procedure for ST in our department.
  
  
  METHODS
  Between June 1995 and June 2013, 648 patients underwent SPD for ST. We included 293 women (45.2 %) and 355 men (54.8 %) with a mean age of 41.1 years (range, 8-74 years) at the onset of dystonia. Surgery was performed at a mean of 3.6 years (range, 1-32 years) after onset of symptoms. Data on clinical presentation, radiological studies, operation tragedy, clinical outcomes and complications were analysed retrospectively. For evaluation of clinical outcomes, patients' responses were assessed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS).
  
  
  RESULTS
  Results were obtained from all 648 patients with a follow-up period ranging from 11 months to 154 months (mean, 33.4 months). The mean preoperative TWSTRS score was 54.7 ± 18.3 points (range, 39-67 points), which decreased to 31.1 ± 11.6 points postoperatively (range, 1-67 points); a significant improvement was observed between preoperative and postoperative TWSTRS evaluation; the clinical improvement of TWSTRS was 73.5 ± 11.9 %. In addition, no deaths and serious complications occurred in this cohort of patients.
  
  
  CONCLUSIONS
  SPD is an effective surgical method for patients with ST. This procedure should be recommended if conservative therapy does not offer satisfactory relief of symptoms.
authors.affiliation: Department of Neurosurgery, Wuhan Central Hospital Affiliated to Tongji Medical College, Wuhan, Hubei, 430014, People's Republic of China.
authors.forename: Junwen
authors.initials: J
authors.lastname: Wang
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Han
authors.forename: Songbo
authors.initials: S
authors.lastname: Guo
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: Zuojun
authors.initials: Z
authors.lastname: Xiong
authors.forename: Jie
authors.initials: J
authors.lastname: Ma
authors.forename: Jian
authors.initials: J
authors.lastname: Liang
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009121:Muscle Denervation / Q000009:adverse effects / Q000379:methods*; D010525:Peripheral Nerves / Q000601:surgery*; D012189:Retrospective Studies; D014103:Torticollis / Q000601:surgery*