改良Foerster-Dandy手术治疗痉挛性斜颈

目的 探讨改良Foerster-Dandy手术治疗痉挛性斜颈的疗效。方法 回顾分析2001年7月至2004年6月显微手术治疗的26例痉挛性斜颈病人，全部采用改良Foerster-Dandy手术，即枕后正中入路硬膜下双侧副神经根、C1脊神经根切断、C2～C4脊神经前、后根选择性部分切断术。结果 全部病人平均随访12．8个月。100％病人术后立即感痉挛状态明显缓解，随访期间缓解率为100％。生活质量提高率在随访期间为96％。术后所有病例发生不同程度转颈无力、耸肩无力、双臂外展受限，随访期间均有所好转，1例病人发生头颈部支撑困难，并因此而影响生活质量。随访期间无复发病例。结论 改良Foerster-Dandy手术是治疗痉挛性斜颈安全有效的手术方法。选择合适病例、熟悉局部解剖、掌握显微手术技巧是保证疗效的关键。

Modified Foerster-Dandy's operation for the treatment of spasmodic torticollis

Objective To study the effectiveness of modified Foerster-Dandy's operation for the treatment of spasmodic torticollis. Methods 26 cases of spasmodic torticollis patients were treated by microsurgical modified Foerster-Dandy's operation from July 2001 to June 2004. Results At follow up evaluation(mean duration: 12.8 months ), this study showed that 100% cases experienced disappearance or notable regression of the spasticity rightly after operation,and the percentage in follow-up duration was 100%. 96% cases had better quality of life by follow-up study. Postoperative complications included muscle weakness of neck (100%) and shoulder (100%) . One patient complained poor quality of life due to severe weakness. There was no recurrence of spasticity during the follow-up duration. Conclusions Modified Foerster-Dandy's operation is an effective microsurgical method for the treatment of spasmodic torticollis. The proper choice of cases, understanding of regional microanatomy and microsurgical techniques are keys to gain good effects.