Cervical Dystonia Induced by Cervical Spine Surgery

Abstract

A case report. 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. 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. 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. Pharmacologic treatment was unsuccessful, but he was successfully treated with local intramuscular injections of botulinum toxin. 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.