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A Knack for Nicking Neck Nerves

Doctors in Japan are trying to improve an operation for a condition called cervical dystonia. This is a problem of unknown cause that affects the muscles around the neck and face. The muscles contract on their own, causing twisting movements and strange postures.

Treatment is usually injections of a drug called botulinum toxin (Botox). Botox is injected into the muscle that is contracting. It blocks the release of chemicals from the nerve to the muscle that tell the muscle when to contract. The muscle becomes "denervated."

Other treatment includes therapy with an occupational or physical therapist. When these treatments fail to correct the problem, surgery may be needed. The doctor uses a microscope to magnify the area and find the nerves to the problem muscles. The nerve root to each muscle involved is cut so the muscle can't contract.

There are many problems with this operation, including blood loss, damage to blood vessels, and loss of feeling. Other problems such as strokes and trouble wallowing or breathing can also happen. For these reasons, doctors are looking for ways to improve the current operation.

Using new microscope technology with high magnification, doctors are able to make a smaller, straighter cut into the skin. Surgeons don't have to move or tug on the nerves or muscles. The nerve roots are easier to see and cut in just the right spot. This new operation has less blood loss, less time in the operating room, and fewer problems after surgery.

References: Takaomi Taira, MD, PhD, et al. A New Denervation Procedure For Idiopathic Cervical Dystonia. In Journal of Neurosurgery: Spine. September 2002. Vol. 97. No. 2. Pp. 201-206.

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