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中华脑科疾病与康复杂志(电子版)

中华脑科疾病与康复杂志(电子版) ›› 2021, Vol. 11 ›› Issue (01) : 23 -26. doi: 10.3877/cma.j.issn.2095-123X.2021.01.006

所属专题： 经典病例； 文献；

周围神经疾患

标准三联术加斜角肌离断治疗侧弯型痉挛性斜颈（附25例报道）
徐浩1, 李俊1, 吴俊1, 王潞1,†()   
  1. 1. 430014　武汉，华中科技大学同济医学院附属武汉中心医院神经外科
  • 收稿日期:2020-01-02 出版日期:2021-02-15
  • 通信作者: 王潞
  • 基金资助:
    武汉市卫生局基金(WX12B14)

Standard triple operation combined with scalenus ablation for the treatment of lateral flexure spasmodic torticollis with 25 cases report

Hao Xu1, Jun Li1, Jun Wu1, Lu Wang1,†()   

  1. 1. Department of Neurosurgery, Central Hospital of Wuhan Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
  • Received:2020-01-02 Published:2021-02-15
  • Corresponding author: Lu Wang
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徐浩, 李俊, 吴俊, 王潞. 标准三联术加斜角肌离断治疗侧弯型痉挛性斜颈（附25例报道）[J]. 中华脑科疾病与康复杂志(电子版), 2021, 11(01): 23-26.

Hao Xu, Jun Li, Jun Wu, Lu Wang. Standard triple operation combined with scalenus ablation for the treatment of lateral flexure spasmodic torticollis with 25 cases report[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2021, 11(01): 23-26.

目的

探讨侧弯型痉挛性斜颈（ST）的手术治疗。

方法

华中科技大学同济医学院附属武汉中心医院神经外科自2014年6月至2019年6月收治25例侧弯型ST患者，通过术前肌电图及CT（或MRI）检查判断主要痉挛肌肉，其中23例行标准三联术加斜角肌离断术，2例仅行斜角肌离断，术后6个月评定疗效。

结果

痊愈17例（68%），显效5例（20%），进步3例（12%），无效0例（0%），无死亡、无致残，无严重并发症。

结论

标准三联术加行痉挛斜角肌离断是治疗侧弯型ST安全、有效的方法。

关键词: 侧弯型痉挛性斜颈, 术前肌电图, 神经切断, 肌切断, 斜角肌
Objective

To investigate the surgical treatment of lateral flexure spasmodic torticollis (ST).

Methods

From June 2014 to June 2019, 25 patients with lateral flexure ST were treated in the Departments of Neurosurgery, Central Hospital of Wuhan Affiliated to Tongji Medical College, Huazhong University of Science and Technology. Preoperative electromyography and CT (or MRI) examination were used to determine the main spastic muscles. Among them, 23 cases of them underwent standard triple operation combined with scalenus ablation, while 2 cases only underwent scalenus ablation surgery. Postoperative efficacy was assessed 6 months after surgery.

Results

Seventeen cases (68%) were cured, 5 cases (20%) were markedly effective, and 3 cases (12%) were improved, 0 case (0%) ineffective with no death, no disability and no serious complications.

Conclusion

Standard triple operation combined with spastic scalenus ablation was a safe and effective method for the treatment of lateral flexure ST.

Key words: Lateral flexure spasmodic torticollis, Preoperative electromyography, Nerve ablation, Muscle ablation, Scalenus
表1 痉挛肌在肌电图的分布情况（Ⅲ痉挛例数/痉挛例数）
参与痉挛的颈肌 头屈向侧 对侧
头夹肌 19/23 1/3
颈夹肌 16/23 1/3
头半棘肌 14/22 S
头最长肌 4/13 S
上斜肌 5/14 S
颈半棘肌 10/18 S
下斜肌 4/12 S
胸锁乳突肌 18/23 S
肩胛提肌 11/17 S
斜方肌 5/11 S
大直肌 3/12 S
斜角肌 18/23 S
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