Surgery for cervical dystonia: the emergence of denervation and myotomy techniques and the contributions of early surgeons at The Johns Hopkins Hospital.

Cervical dystonia is a psychologically and physically disabling disease that has intrigued clinicians since the early history of surgery. Because of its elusive etiology, its operative treatment has had an extended evolutionary voyage. Early surgical approaches involved resection of the sternocleidomastoid muscle. Later recognition of more diffuse involvement of the posterior neck muscles led to the introduction of new techniques with more effective results. A review of available surgical patient records at The Johns Hopkins Hospital from around the turn of the 20th century provided a glimpse of the early history of the operative treatment for torticollis through the work of some of the leaders of surgery, including Halsted, Cushing, and specifically Finney. Here, the authors present a segment of history on the surgical treatment of this disease as it relates to the introduction of myotomy and denervation techniques.