Accessory spinal nerve damage during a cervical lymph node biopsy: case report.

Area of Science:

• Neurology
• Surgical Anatomy

Background:

• Iatrogenic injury to the accessory spinal nerve is a recognized complication of neck surgery.
• Cervical lymph node biopsies, particularly for suspected tuberculosis, carry a risk of nerve damage.

Observation:

• A 30-year-old patient developed shoulder dysfunction and hand symptoms post-right jugulocarotid lymph node biopsy.
• Clinical examination revealed shoulder limitation and trapezius muscle wasting.
• Electromyography (EMG) indicated axonotmesis of the accessory spinal nerve.

Findings:

• Magnetic resonance imaging (MRI) confirmed trapezius muscle atrophy with denervation edema.
• The patient experienced functional impairment of the right shoulder and hand.

Implications:

• Accessory spinal nerve damage necessitates prompt diagnosis, primarily through EMG.
• Rehabilitation is the initial treatment of choice, with surgery considered for refractory cases.
• Surgeons must prioritize accessory spinal nerve protection during cervical lymph node procedures.