Isolated Spinal Accessory Nerve Palsy from Volleyball Injury.

Area of Science:

• Neurology
• Orthopedic Surgery
• Sports Medicine

Background:

• Spinal accessory nerve (SAN) palsy typically follows posterior triangle surgery, leading to trapezius muscle paralysis and shoulder dysfunction.
• This case presents an unusual cause of SAN palsy in a competitive volleyball player due to a diving injury.

Purpose of the Study:

• To report an atypical case of SAN palsy resulting from a sports injury.
• To highlight the effectiveness of scapulopexy in managing delayed SAN palsy with trapezius atrophy.

Main Methods:

• A 19-year-old volleyball player with shoulder weakness, dyskinesia, and pain after a diving injury was evaluated.
• Physical examination revealed scapular winging and weakness, prompting surgical intervention.
• Scapulopexy was performed to stabilize the inferior angle of the scapula.

Main Results:

• The patient presented with symptoms 2 years after the initial injury.
• Postoperative assessment at 6 months showed full active range of motion in the shoulder.
• The surgical intervention successfully addressed the shoulder dysfunction despite complete trapezius atrophy.

Conclusions:

• Spinal accessory nerve palsy can result from seemingly routine athletic maneuvers, potentially due to muscle hypertrophy and overstretching.
• Scapulopexy is a viable treatment option for delayed SAN palsy, achieving satisfactory functional recovery.
• This case underscores the importance of considering non-surgical etiologies for shoulder dysfunction in athletes.