Authors' objectives:

This study aims to assess the effectiveness of selective denervation, with or without transection of cervical muscles, for treating spasmodic torticollis.

Authors' recommendations: The only results available are from uncontrolled case series. The case series design is highly subject to selection, recording and follow-up bias and is unreliable for comparing one treatment modality with alternatives. The studies found that selective denervation, with or without muscle resection, nearly always produces a substantial improvement in the symptoms of participants who were followed up. However, any suggestion of benefit assumes that pre and post-surgical symptoms were assessed with reliable tools and without appreciable bias. Applicability of results is limited because the studies reported few participants who had been treated with botulinum toxin, which might have obviated the need for surgery. The limited quality of the studies do not permit any reliable comparison with other treatments, most importantly local injection of botulinum toxin. Similarly, we are unable to draw reliable conclusions about how to select patients who might benefit, or about benefit or adverse effects in the longer term.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.wihrd.soton.ac.uk

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: Wessex Institute for Health Research and Development

Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662

Copyright: Bazian Ltd, Wessex Institute for Health Research and Development