Cervical dystonia induced by cervical spine surgery: a case report

Spine (Phila Pa 1976). 2006 Jan 1;31(1):E31-4. doi: 10.1097/01.brs.0000193928.16048.cb.

Abstract

Study design: A case report.

Objectives: To describe an interesting patient who underwent a three-level corpectomy of the cervical spine complicated by cervical dystonia and eventually treated successfully with botulinum toxin injections.

Summary of background data: Cervical dystonia is a relatively rare disease and unfamiliar to many clinicians. Various types of peripheral trauma or peripheral lesion have been reported to induce cervical dystonia. However, to the best of our knowledge, there have been no reports about cervical dystonia following cervical spine surgery.

Methods: We present a case of a 45-year-old man who developed severe axial neck pain after cervical anterior corpectomy and fibula strut grafting due to cervical myelopathy. His neck pain gradually worsened, and involuntary spasmodic neck movement developed 6 weeks after operation when his halo-vest was removed. Initially, we considered his complaint to be transient or psychogenic, and diagnosis of cervical dystonia was delayed until 14 weeks after operation.

Results: Pharmacologic treatment was unsuccessful, but he was successfully treated with local intramuscular injections of botulinum toxin.

Conclusions: It must be kept in mind that cervical spine surgery is not an exceptional precipitator of cervical dystonia, despite the fact that it is extremely rare.

Publication types

  • Case Reports

MeSH terms

  • Anti-Dyskinesia Agents / therapeutic use
  • Botulinum Toxins / therapeutic use
  • Cervical Vertebrae / surgery*
  • Humans
  • Male
  • Middle Aged
  • Neck Pain / etiology*
  • Neck Pain / physiopathology
  • Postoperative Complications*
  • Spinal Cord Compression / etiology*
  • Spinal Cord Compression / physiopathology
  • Spinal Fusion / adverse effects*
  • Spinal Fusion / instrumentation
  • Spinal Fusion / methods
  • Torticollis / drug therapy
  • Torticollis / etiology*
  • Torticollis / physiopathology
  • Treatment Outcome

Substances

  • Anti-Dyskinesia Agents
  • Botulinum Toxins