PDF(Pubmed)
Abstract：
Cervical dystonia, characterized by the involuntary contraction of cervical muscles, is the most common form of adult dystonia. In a patient with intractable cervical dystonia, we carried out a myotomy of the left obliquus capitis inferior and selective peripheral denervation (SPD) of the posterior branches of the C3-C6 spinal nerves based on preoperative 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT). The patient was a 65-year-old, right-handed man with an unremarkable medical history. His head rotated involuntarily to the left. Medication and botulinum toxin injections were ineffective, and surgical treatment was considered. 18F-FDG PET/CT imaging revealed FDG uptake in the left obliquus capitis inferior, right sternocleidomastoideus, and left splenius capitis. Myotomy of the left obliquus capitis inferior and SPD of the posterior branches of the C3-C6 spinal nerves was performed under general anesthesia. During the 6-month follow-up, the patient\'s Toronto Western Spasmodic Torticollis Rating Scale score improved from 35 to 9. This case shows that preoperative 18F-FDG PET/CT is effective in identifying dystonic muscles and determining the surgical strategy for cervical dystonia.
摘要：
颈肌张力障碍,以颈椎肌肉的不自主收缩为特征，是成人肌张力障碍最常见的形式。在患有难治性宫颈肌张力障碍的患者中，我们根据术前18F-氟代脱氧葡萄糖(18F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)对C3-C6脊神经后支的左斜头肌切开术和选择性外周神经支配(SPD)进行了切开术.病人65岁,有着平淡无奇病史的右撇子.他的头不由自主地向左旋转。药物和肉毒杆菌毒素注射无效，并考虑手术治疗。18F-FDGPET/CT显像提示左斜头炎有FDG摄取，右胸锁乳突,和左脾炎。在全身麻醉下进行左斜头炎的肌切开术和C3-C6脊神经后支的SPD。在6个月的随访中，患者的多伦多西部痉挛性斜颈评定量表评分从35分提高到9分。此病例表明，术前18F-FDGPET/CT可有效识别肌张力障碍并确定宫颈肌张力障碍的手术策略。
