Freidman M. Microsurgical denervation in the surgical treatment of spastic torticollis

The thesis presents theoretical generalization and new solution-date scientific and applied problem Neurosurgery - improving the outcomes of patients with spastic torticollis using selective selective denervation of the muscles of the shoulder-blade triangle which participate in the formation of symptom ST. Results of treatment of 72 patients with spastic torticollis using microsurgical denervation procedures, which were treated in the clinic Reconstructive Neurosurgery with X-ray of the operating room State Institution "Acad. A.P. Romodanova Institute of Neurosurgery NAMS Ukraine "for 1999 - 2015 years. The main criterion for inclusion of patients in the study was the presence of isolated, clinically significant SC resistant to conservative therapies. To assess the severity and disability of patients as the source, and after the surgery conducted a survey method used for TWSTRS (Toronto Western Spasmodic Torticollis Rating Scale). Selective microsurgical denervation surgery in the neck for the treatment of spastic torticollis divided into two main types, depending on the anatomical location of the muscle groups that are involved in the formation of the clinical picture ST: denervation of sternocleidomastoideusmuscle (SCM) and denervation of back muscle groups of neck (BMGN) - selective ramisektomiya back of the neck (SRB). The third type of surgical intervention of denervation-muscle denervation shoulder-blade triangle (DMPLT), we have developed during this study after study results of surgical treatment methods commonly used denervation. In general, patients with IC 154 was performed microsurgical denervation surgery: 58 - SCM denervation, microsurgical denervation of BMGN - 66 and 30 -DMPLT. In the analysis of long-term results of surgical treatment, which involved the use of both standard and proposed in this study new methods of selective denervation statistically significant impact carried denervation surgery to reduce the level of disability and reduce the severity of the disease with spastic torticollis patients such forms as retrokolis, laterokolis and tortikolis.