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Iatrogenic spinal accessory nerve palsy.

R J King, G Motta

    Annals of the Royal College of Surgeons of England
    |January 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

    Iatrogenic accessory nerve palsy, often diagnosed late, causes trapezius muscle wasting and shoulder dysfunction. Early recognition and proper surgical techniques are crucial for managing this condition.

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    Area of Science:

    • Orthopaedic Surgery
    • Neurology
    • Surgical Complications

    Background:

    • Iatrogenic accessory nerve palsy can result from surgical procedures.
    • Delayed diagnosis is common, with symptoms like trapezius muscle wasting and shoulder dysfunction appearing months post-surgery.

    Purpose of the Study:

    • To discuss the reasons for delayed diagnosis of iatrogenic accessory nerve palsy.
    • To outline prophylaxis and surgical treatment techniques for this condition.
    • To highlight diagnostic methods, including electromyography.

    Main Methods:

    • Case review of four patients with severe iatrogenic accessory nerve palsy requiring surgical intervention.
    • Discussion of diagnostic delays, prophylactic measures, and surgical techniques.
    • Mention of electromyography as a diagnostic tool.

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    Main Results:

    • Definitive diagnosis was delayed for several months in the presented cases.
    • Symptoms include trapezius muscle wasting and significant shoulder dysfunction.
    • Less severe cases may present during activities requiring hands above shoulder level.

    Conclusions:

    • Prompt recognition of accessory nerve injury is essential to prevent long-term complications.
    • Adherence to proper surgical techniques and prophylactic measures can minimize the risk of iatrogenic palsy.
    • Electromyography aids in confirming the diagnosis, especially in milder cases.