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Spinal accessory nerve injury.

J M Wiater1, L U Bigliani

  • 1Shoulder Service, New York Orthopaedic Hospital, Columbia-Presbyterian Medical Center, NY, USA.

Clinical Orthopaedics and Related Research
|December 29, 1999
PubMed
Summary
This summary is machine-generated.

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Injury to the spinal accessory nerve causes trapezius palsy, leading to shoulder dysfunction. Early microsurgical reconstruction or later muscle transfer procedures like Eden-Lange can restore function and relieve pain.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Anatomy

Background:

  • The trapezius muscle is crucial for scapular stability and shoulder function.
  • The spinal accessory nerve's superficial location makes it vulnerable to injury, often iatrogenically.
  • Trapezius palsy results in shoulder drooping, scapular winging, and pain.

Purpose of the Study:

  • To review the causes, presentation, and treatment options for spinal accessory nerve injury and subsequent trapezius palsy.
  • To highlight the importance of timely diagnosis and intervention.

Main Methods:

  • Review of literature on spinal accessory nerve injury and trapezius palsy.
  • Discussion of diagnostic evaluations, including electrodiagnostic examinations.
  • Analysis of surgical and conservative treatment modalities.

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Main Results:

  • Iatrogenic injury is a common cause of trapezius palsy.
  • Early diagnosis (within 1 year) favors microsurgical nerve reconstruction.
  • The Eden-Lange procedure is effective for irreparable nerve damage.

Conclusions:

  • Spinal accessory nerve injury leads to significant shoulder dysfunction and pain.
  • Treatment strategies vary based on injury timing and patient factors.
  • Surgical interventions, including nerve repair and muscle transfer, can restore function.