Posterior approach for accessory-suprascapular nerve transfer: an electrophysiological outcomes study

The aim of this study was to retrospectively investigate the electrophysiological results obtained after employing the posterior approach for spinal accessory nerve-suprascapular nerve (SAN-SSN) transfer, and to compare this with the traditional anterior approach. SAN-SSN transfer was performed in 74 patients with brachial plexus injury. The posterior approach was used in 35 patients and the anterior approach was used in 39 patients. Electrophysiological examination was conducted and analyzed postoperatively. There was no significant difference between approaches in the time it took for the infraspinatus to show low-incidence motor unit action potentials (MUAPs) and an incomplete interference pattern. In addition, the final ratio of patients that showed regeneration potential of the infraspinatus was not significantly different between the approaches. Furthermore, latency and wave amplitude showed a linear regression with post-operative time in the posterior approach group. In the posterior approach group, the final abduction of the shoulder was positively correlated with the amplitude. The posterior approach for SAN-SSN is an effective potential alternative technique that may be appropriate for some clinical situations.