Diagnosis and treatment of iatrogenic spinal accessory nerve injury

Paul G. Matz, Nicholas Barbaro

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Although iatrogenic injury to the spinal accessory nerve in the posterior cervical triangle is a well-described phenomenon, diagnosis can prove difficult and is often incorrect or delayed. We describe a series of six men and three women (mean age 40 years; range, 20 to 52 years) with iatrogenic spinal accessory nerve injuries. Injuries resulted from lymph node biopsies in the posterior cervical triangle in eight patients and posterior fossa surgery in one. Eight patients lost the ability to abduct their arm but could still shrug their shoulder, a pattern that resulted in an incorrect initial diagnosis in five patients. The average delay from injury to referral was 8 months. Seven patients underwent nerve exploration an average of 9.7 months after injury. Five had transected nerves that could be repaired; three of these patients required a nerve graft. Pain was greatly relieved in the five patients who had severe pain before surgery, and weakened shoulder abduction improved in four of six patients. Nerve exploration should be considered when the patient's clinical exam does not improve within 3 months of injury. Nerve repair frequently reduces pain and improves shoulder abduction, even 12 months after injury.

Original languageEnglish (US)
Pages (from-to)682-685
Number of pages4
JournalAmerican Surgeon
Volume62
Issue number8
StatePublished - 1996
Externally publishedYes

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Accessory Nerve Injuries
Wounds and Injuries
Therapeutics
Pain
Shoulder Pain
Aptitude
Arm
Referral and Consultation
Lymph Nodes

ASJC Scopus subject areas

  • Surgery

Cite this

Diagnosis and treatment of iatrogenic spinal accessory nerve injury. / Matz, Paul G.; Barbaro, Nicholas.

In: American Surgeon, Vol. 62, No. 8, 1996, p. 682-685.

Research output: Contribution to journalArticle

Matz, PG & Barbaro, N 1996, 'Diagnosis and treatment of iatrogenic spinal accessory nerve injury', American Surgeon, vol. 62, no. 8, pp. 682-685.
Matz, Paul G. ; Barbaro, Nicholas. / Diagnosis and treatment of iatrogenic spinal accessory nerve injury. In: American Surgeon. 1996 ; Vol. 62, No. 8. pp. 682-685.
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