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Spinal accessory nerve in a trapezius-splitting surgical approach
C M Jobe1, W E Kropp, V E Wood
1Department of Orthopaedic Surgery, Loma Linda University, School of Medicine, CA 92350, USA.
Journal of Shoulder and Elbow Surgery
|May 1, 1996
Summary
Muscle-splitting incisions in the trapezius muscle are safe in the lateral 50% but risky in the medial half. This study mapped the spinal accessory nerve
Area of Science:
- Anatomy
- Surgical Anatomy
- Orthopedic Surgery
Background:
- The trapezius muscle is crucial for shoulder function.
- Understanding the anatomical safe zones for surgical incisions is vital to prevent nerve damage.
Purpose of the Study:
- To determine the safe limits for muscle-splitting incisions of the trapezius muscle.
- To map the course and branching of the spinal accessory nerve relative to anatomical landmarks.
Main Methods:
- Dissection of 25 cadaver shoulders.
- Measurement of nerve distances relative to the vertebral spinous processes and acromion.
- Analysis of the spinal accessory nerve's vertical course and branch distribution.
Main Results:
- The spinal accessory nerve runs vertically, medial and parallel to the scapular vertebral border.
- Nerve branches are located between 33% and 50% of the distance from the vertebral spinous processes to the acromion.
- The most lateral nerve branch averages 44% and never exceeds 50% of this distance.
Conclusions:
- Muscle-splitting incisions are safe within the lateral 50% of the trapezius muscle.
- Incisions in the medial half of the trapezius muscle should be avoided or performed with extreme caution due to proximity to the spinal accessory nerve.