الفهرس | Only 14 pages are availabe for public view |
Abstract Our results suggest that cervical dystonia can be effectively treated without major complications. Patients that are refractory to conservative medical treatment may be surgical candidates. In contrast with botulinum toxin which provide only a short-term relief of symptoms and require repeated injections, surgical interventions can result in a long-term improvement in abnormal dystonic activity. Moreover, patients with muscle contractures may not improve with botulinum toxin injection but may possibly benefit from surgery when denervation is combined with myotomy. Several surgical options are available for treating patients with cervical dystonia and the selection of the appropriate surgical options is a prominent issue, therefore therapy must be individualized. The treatment plan and choice of surgical option usually depends on several factors, including age of the patient, clinical type of cervical dystonia, etiology of cervical dystonia, previous exposure to medications, previous trials of botulinum toxin injection, medical condition, prior surgery, cost, and patient’s preference. However, the prognostic factors determining favorable outcomes for which patient will respond better to a specific type of surgery has not been determined. Therefore, further randomized, blinded, studies with longer follow up period is needed to allow identification of patient’s characteristics which favors one surgical option over the other, and long-term effect of each surgical option. |