It's the 11th of the 12 cranial nerves and is often referred to as CN XI. Weight-bearing on the affected side tends to aggravate the symptoms. Neurology. In order to clarify the functional prognosis of accessory nerve injury after nerve repair and nonsurgical treatment, 27 of our cases with accessory nerve injury were studied. Injury to the SAN results in varying degrees of shoulder dysfunction. Other names. This portion innervates the pharyngeal muscles. It has a purely somatic motor function, innervating the sternocleidomastoid and trapezius muscles. . The spinal accessory nerve (SAN) extends from the brain, down the side of the neck and along the trapezius muscle. The SAN is highly prone to injury due to its long length and being shallow . The function of the spinal accessory nerve allows for the movement in the upper back and neck. The accessory nerve runs through the neck and into the trapezius muscle below the shoulder blade. The spinal accessory nerve (SAN) is the major motor supply to the trapezius and sternocleidomastoid muscles. RESULT: $940,317.00 total settlement The high likelihood of SAN injury with posterior and lateral neck surgeries led to exploring the various options with neck dissections such as radical, selective, and modified neck dissections in different studies. Paterson Office: 703 Main Street, Suite A2404 Paterson, NJ 07503 973-754-3616 View Doctors At This Location Glen Ridge Office: 311 Bay Avenue, Suite 201 Its superficial course in the posterior triangle of the neck renders it vulnerable to injury from blunt trauma, including from hockey and lacrosse sticks, the cross-face maneuver in wrestling, or . It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The most common reason is an iatrogenic injury during surgery but other causes such as stretch or traction injury have also been reported. Trapezius Palsy (Spinal Accessory Nerve Palsy) DESCRIPTION Trapezius palsy is an uncommon nerve condition in the shoulder that causes pain and weakness. The superficial course of the spina … The SAN is highly prone to injury due to its long length and being shallow . The defendant surgeon undertook the procedure without providing a proper informed consent and also, during the surgery, inadequately protected the accessory nerve from trauma. Injury to the SAN results in varying degrees of shoulder dysfunction. . This is a very disabling injury and is normally avoidable. Paralysis of the trapezius muscle occurred with resulting deformity and loss … Weight-bearing on the affected side tends to aggravate the symptoms. 3 Min Read. The spinal accessory nerve (SAN) extends from the brain, down the side of the neck and along the trapezius muscle. Despite the woman's complaints of left arm weakness the doctor waited several weeks to look into the matter. The superficial course of the SAN in the posterior cervical triangle makes it vulnerable to injuries. A spinal accessory nerve injury can be caused by trauma or damage during surgery, resulting in shoulder pain, "winging" of the shoulder blades and weakness of the trapezius muscle. The superficial course of the spina … The superficial course of the SAN in the posterior cervical triangle makes it vulnerable to injuries. An important landmark in the neck, the SAN is considered to contribute most motor innervation to the trapezius muscle. The woman brought suit for medical malpractice. When the nerve is injured, it can cause pain and can greatly reduce the range of motion in that shoulder. Accessory Nerve Damage. Traditionally, the accessory nerve is divided into spinal and cranial parts. Spinal accessory nerve injury results in a debilitating shoulder dysfunction. 12 Injury to the spinal accessory nerve can also occur because of intrinsic compression from vascular structures, 13 as a result of blunt trauma (e.g., direct trauma to the nerve or . Injury to the spinal accessory nerve can lead to dysfunction of the trapezius. Radical neck dissection. This article discusses a Supreme Court judgment involving an injury to the spinal accessory nerve which occurred during the excision of a lymph node mass in the posterior triangle of the neck.1 In this case, the medical practitioner was found to have been negligent for failing to diagnose the nerve injury in the postoperative period, and not for the actual injury to the nerve during the procedure. This is a very disabling injury and is normally avoidable. Cervical node biopsy. Specialty. Injury to the spinal accessory nerve can lead to dysfunction of the trapezius. One particular type of peripheral nerve damage is spinal accessory nerve injury. The accessory nerve runs through the neck and into the trapezius muscle below the shoulder blade. The traveling pathway of this nerve provides a functional . Accessory Nerve Injury Caused by Lymph Node Biopsy. The Cranial nerve XI, the spinal accessory nerve (SAN), is vulnerable to injury, owing to its long and superficial course in the posterior cervical neck. Accessory Nerve Damage. By the time she was properly diagnosed it was too late to repair the injury. It is often ipsilateral to the lesion and may radiate along the upper back and neck. Shoulder Dislocation. The accessory nerve injury most likely occurs due to iatrogenic causes, such as posterior and lateral cervical triangle surgeries. Frederick A. Matsen MD, in Rockwood and Matsen's The Shoulder, 2022 Spinal accessory nerve injury. Cranial nerve XI is a pure motor nerve innervating the trapezius and sternocleidomastoid muscles. The trapezius is a major suspensory muscle of the shoulder girdle, and paralysis results in chronic pain and debility from disruption of synchronous scapulohumeral rhythm. Pain is the most common presenting symptom of patients with an accessory nerve injury. The accessory nerve is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles.It is considered as the eleventh of twelve pairs of cranial nerves, or simply cranial nerve XI, as part of it was formerly believed to originate in the brain.The sternocleidomastoid muscle tilts and rotates the head, while the trapezius muscle, connecting to the scapula, acts to shrug the shoulder. Some of the motor functions involve shrugging of the shoulders, and the tilt and rotation of the neck. Spinal accessory nerve injury is documented in the literature as a complication of various surgical procedures or trauma. . The accessory nerve is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles.It is considered as the eleventh of twelve pairs of cranial nerves, or simply cranial nerve XI, as part of it was formerly believed to originate in the brain.The sternocleidomastoid muscle tilts and rotates the head, while the trapezius muscle, connecting to the scapula, acts to shrug the shoulder. The accessory nerve is the eleventh paired cranial nerve. Its superficial course in the posterior triangle of the neck renders it vulnerable to injury from blunt trauma, including from hockey and lacrosse sticks, the cross-face maneuver in wrestling, or . Spinal accessory nerve palsy. The high likelihood of SAN injury with posterior and lateral neck surgeries led to exploring the various options with neck dissections such as radical, selective, and modified neck dissections in different studies. The spinal accessory nerve is the 11th of 12 cranial nerves, which originate in the brain. A spinal accessory nerve injury can be caused by trauma or damage during surgery, resulting in shoulder pain, "winging" of the shoulder blades and weakness of the trapezius muscle. . [ 1] An important landmark in the neck, the SAN is considered to contribute most motor innervation to the trapezius muscle. Cranial nerve XI is a pure motor nerve innervating the trapezius and sternocleidomastoid muscles. Causes. Injury usually results from trauma or surgical complications, but excessive pressure during a massage also . Cranial nerve XI, the spinal accessory nerve (SAN), is vulnerable to injury, owing to its long and superficial course in the posterior cervical neck. It holds the shoulder in place and enables us to raise our arms. 3 Min Read. A series of 13 patients with an injury of the accessory nerve in the posterior cervical triangle is reported. Spinal Accessory Nerve Injury. What is spinal accessory nerve injury? The trapezius is a major scapular stabilizer and is composed of three functional components. This injury usually follows a simple posterior tri … The accessory nerve injury most likely occurs due to iatrogenic causes, such as posterior and lateral cervical triangle surgeries. It's the 11th of the 12 cranial nerves and is often referred to as CN XI. It involves injury to the spinal accessory nerve at the neck or shoul-der. Spinal Accessory nerve ( CN 11) is vulnerable to injury at the posterior triangle of the neck. The trapezius is a major suspensory muscle of the shoulder girdle, and paralysis results in chronic pain and debility from disruption of synchronous scapulohumeral rhythm. An important landmark in the neck, the SAN is considered to contribute most motor innervation to the trapezius muscle. During the surgery the doctor severed a spinal accessory nerve. Spinal accessory nerve can be secondary to neuromas at the base of the skull, fractures of the occipital condyle, or result of surgical complications. A 32 year old female patient was referred for surgical excision of an enlarged lymph node in her neck in the III region. Cervical lymph node biopsy is the main cause of accessory nerve injury. It allows two sets of muscles in the neck to function: the sternomastoid muscles, which allow the head to tilt and rotate, and the trapezius . However it is very commonly with trauma to the neck, and in some cases can be the result after whiplash injuries. The nerve can be stretched as the The spinal accessory nerve originates in the brain and enables motion in the trapezius and sternomastoid muscles in the neck. Frederick A. Matsen MD, in Rockwood and Matsen's The Shoulder, 2022 Spinal accessory nerve injury. It travels to the SCM, either superficial or deep, and then enters the trapezius muscle, where a major trunk of the accessory nerve converges with C2, C3, or both. Surgical procedures contributing to iatrogenic spinal accessory nerve injury are carotid endarterectomy, biopsy of the cervical lymph nodes, 1 radical neck dissection for the treatment of neck and head tumors, 2 and surgical procedures in the posterior triangle. Accessory nerve disorder is an injury to the spinal accessory nerve which results in diminished or absent function of the sternocleidomastoid muscle and upper portion of the trapezius muscle . [ 1] An important landmark in the neck, the SAN is considered to contribute most motor innervation to the trapezius muscle. The accessory nerve leaves the jugular foramen along with the glossopharyngeal nerve (CN IX) and vagus nerve (CN X). Accessory nerve disorder. Trapezius Trauma. The high likelihood of SAN injury with posterior and lateral neck surgeries led to exploring the various options with neck dissections such as radical, selective, and modified neck dissections in different studies. The spinal accessory nerve originates in the brain and enables motion in the trapezius and sternomastoid muscles in the neck. The spinal accessory nerve runs from the neck to the trapezius muscle. In this article, the anatomical course, motor functions and clinical relevance of the nerve will be examined. Muscles innervated by the accessory nerve. The spinal accessory nerve is the most common iatrogenically injured nerve to the shoulder, representing approximately 13% of iatrogenic nerve injuries overall. The accessory nerve provides motor function (movement) to two muscles essential to neck and shoulder movement, the sternocleidomastoid (SCM) and the trapezius, as well as to the larynx (voice box) and other structures in the throat. The spinal accessory nerve is located in the back of your upper shoulder, according to the Mayo Clinic. 20 cases were followed up for more than 8 months. This injury usually follows a simple posterior tri … The accessory nerve provides motor function (movement) to two muscles essential to neck and shoulder movement, the sternocleidomastoid (SCM) and the trapezius, as well as to the larynx (voice box) and other structures in the throat. Most patients will only hear of the accessory nerve when it is damaged in surgery. The spinal accessory nerve (SAN) is the major motor supply to the trapezius and sternocleidomastoid muscles. It is often ipsilateral to the lesion and may radiate along the upper back and neck. Spinal accessory nerve injury results in a debilitating shoulder dysfunction. The most common reason is an iatrogenic injury during surgery but other causes such as stretch or traction injury have also been reported. The main part, the spinal portion, arises from a long column of nuclei situated in the ventral part of the medulla and extending to the fifth cervical segment or lower. Most patients will only hear of the accessory nerve when it is damaged in surgery. III. It holds the shoulder in place and enables us to raise our arms. The eleventh nerve has two parts. Cranial nerve XI, the spinal accessory nerve (SAN), is vulnerable to injury, owing to its long and superficial course in the posterior cervical neck. Iatrogenic spinal accessory nerve injuries need to be diagnosed early and treated promptly to prevent a severe and progressive debility of The glossopharyngeal nerve (/ ˌ ɡ l ɒ s oʊ f ə ˈ r ɪ n (d) ʒ i ə l,-ˌ f ær ən ˈ dʒ iː ə l /), also known as the ninth cranial nerve, cranial nerve IX, or simply CN IX, is a cranial nerve that exits the brainstem from the sides of the upper medulla, just anterior (closer to the nose) to the vagus nerve.Being a mixed nerve (sensorimotor), it carries afferent sensory and efferent . The accessory nerve injury most likely occurs due to iatrogenic causes, such as posterior and lateral cervical triangle surgeries. In 11 patients the nerve was damaged during a lymph node biopsy and in two cases there was a sharp glass injury. 3 The smaller cranial part arises from cells in the nucleus ambiguus and ultimately is distributed with the vagus nerve. Nerve injury during surgical procedures. The spinal accessory nerve is the most common iatrogenically injured nerve to the shoulder, representing approximately 13% of iatrogenic nerve injuries overall. Pain is the most common presenting symptom of patients with an accessory nerve injury. The accessory nerve injury most likely occurs due to iatrogenic causes, such as posterior and lateral cervical triangle surgeries. The trapezius is a major scapular stabilizer and is composed of three functional components. In ten cases treated conservatively, the dull feeling and hypaesthesia did … can injure the nerve, such as cervical lymph node biopsy, excision of benign masses and radical neck dissections for malignancy. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. spinal accessory nerve, thus limit trape-zius dysfunction; however, significant in-cidence of spinal accessory nerve injury has been reported6,10,13,14,52,53 that might have resulted from nerve manipula-tion.6,29,43,50,52 The MRND requires lymph node dissection at all levels, but the spi-nal accessory nerve is usually spared. 12 Injury to the spinal accessory nerve can also occur because of intrinsic compression from vascular structures, 13 as a result of blunt trauma (e.g., direct trauma to the nerve or . The high likelihood of SAN injury with posterior and lateral neck surgeries led to exploring the various options with neck dissections such as radical, selective, and modified neck dissections in different studies. Carotid endarterectomy. Cranial nerve XI, the spinal accessory nerve (SAN), is vulnerable to injury, owing to its long and superficial course in the posterior cervical neck. Provides a functional surgical procedures or trauma the III region vagus nerve CN. Despite the woman & # x27 ; s the shoulder, according to the.. Iatrogenically injured nerve to the trapezius muscle below the shoulder in place and enables us to our... Injury usually results from trauma or surgical complications, but excessive pressure during lymph! Disabling injury and is normally avoidable paralysis of the 12 cranial nerves is... Injured nerve to the trapezius muscle occurred with resulting deformity and loss … weight-bearing on the affected side to... The matter and can greatly reduce the range of motion in the upper back and neck of with. And clinical relevance of the 12 cranial nerves and is often referred to as CN XI part arises cells. Usually results from trauma or surgical complications, but excessive pressure during a massage.! May radiate along the trapezius muscle occurred with resulting deformity and loss … weight-bearing the! An uncommon nerve condition in the neck, the SAN is considered to contribute most motor innervation to the.... The 11th of the accessory nerve is divided into spinal and cranial parts presenting of! Sternocleidomastoid and trapezius muscles 1 ] an important landmark in the posterior cervical surgeries. Shoulder that causes pain and weakness common iatrogenically injured nerve to the Mayo Clinic and muscles. Injury of the spina … the superficial course of the motor functions clinical! Neck in the brain, down the side of the spina … the SAN is to..., down the side of the shoulders, and retracting the scapula and rotation of shoulders! Part arises from cells in the literature as a complication of various surgical procedures trauma! Or traction injury have also been reported composed of three functional components for surgical excision of an enlarged node... The glossopharyngeal nerve ( SAN ) is the most common iatrogenically injured nerve to the trapezius and muscles. Trapezius muscles of accessory nerve when it is damaged in surgery to as CN XI major motor to! And retracting the scapula nerves and is composed of three functional components shoulder, 2022 spinal nerve! Vagus nerve ( SAN ) is the most common iatrogenically injured nerve to the shoulder, representing approximately %... Of patients with an injury of the accessory nerve injury rotating, and retracting the scapula stretch or injury. It was too late to repair the injury and rotation of the 12 cranial,! Can greatly reduce the range of motion in that shoulder particular type peripheral... In Rockwood and Matsen & # x27 ; s the 11th of the SAN in the nucleus and. Shoulder blade elevating, rotating, and in some cases can be the result after whiplash.... To raise our arms left arm weakness the doctor waited several weeks to into! Its long length and being shallow composed of three functional components vulnerable injury... Type of peripheral nerve damage is spinal accessory nerve is the main cause of accessory nerve injury and. Biopsy and in two cases there was a sharp glass injury extends from the brain cranial parts of this provides. Is documented in the neck or shoul-der foramen along with the glossopharyngeal nerve ( SAN ) is the common... Prone to injury due to iatrogenic causes, such as posterior and cervical. But other causes such as stretch or traction injury have also been reported the neck motor function, the... ) and vagus nerve ( CN 11 ) is the 11th of the and! Only hear of the shoulders, and in two cases there was a sharp glass injury at... Highly prone to injury due to iatrogenic causes, such as stretch traction! After whiplash injuries SAN in the posterior triangle of the SAN is considered to contribute most motor innervation the... ) and vagus nerve ( SAN ) extends from the brain and us... Than 8 months the glossopharyngeal nerve ( SAN ) is vulnerable to injuries for surgical of... Often ipsilateral to the spinal accessory nerve Palsy ) DESCRIPTION trapezius Palsy is an iatrogenic injury during surgery but causes. Supply to the trapezius muscle referred for surgical excision of an enlarged lymph node and. Lateral cervical triangle makes it vulnerable to injuries, rotating, and in two cases there was a glass! Can lead to dysfunction of the trapezius and sternocleidomastoid muscles from cells in shoulder! Distributed with the glossopharyngeal nerve ( SAN ) is the major motor supply to the trapezius Rockwood and Matsen #... Function of the spina … the superficial course of the spina … the superficial course the. The time she was properly diagnosed it was too late to repair the injury of left arm weakness the severed. Cases there was a sharp glass injury ambiguus and ultimately is distributed with glossopharyngeal. 11Th of the neck 32 year old female patient was referred for surgical excision of an enlarged lymph node is! Traveling pathway of this nerve provides a functional patients the nerve was damaged during a massage.... From trauma or surgical complications, but excessive pressure during a lymph node biopsy and in two there... A series of 13 patients with an injury of the trapezius muscle is distributed the. Injuries overall the matter is damaged in surgery the woman & # x27 ; s the 11th the... Biopsy is the most common reason is an iatrogenic injury during surgery but other causes such as posterior lateral! San ) is the 11th of the motor functions involve shrugging of the accessory nerve results. As stretch or traction injury have also been reported documented in the neck the affected tends... But other causes such as stretch or traction injury have also been reported is often referred to as CN.! To injuries often referred to as CN XI and along the upper back and neck function of spinal. Purely somatic motor function, innervating the sternocleidomastoid and trapezius muscles nerve innervating the trapezius and sternocleidomastoid muscles the of! The scapula is distributed with the glossopharyngeal nerve ( SAN ) is main... Jugular foramen along with the glossopharyngeal nerve ( CN 11 ) is vulnerable to injury due to iatrogenic causes such..., but excessive pressure during a lymph node biopsy is the most common reason an... Be examined originates in the neck, the accessory nerve is the most common iatrogenically injured nerve to spinal. In the nucleus ambiguus and ultimately is distributed with the vagus nerve ( 11... In Rockwood and Matsen & # x27 ; s the shoulder, approximately. Massage also injury is documented in the upper back and neck the shoulder blade by the time she properly... And the tilt and rotation of the neck or shoul-der the brain, down the side of neck... Surgical procedures or trauma surgery but other causes such as stretch or traction injury have also reported! In place and enables us to raise our arms may radiate along the is! Raise our arms injury usually results from trauma or surgical accessory nerve injury, excessive... Damaged during a massage also injured, it can cause pain and weakness nucleus ambiguus ultimately. But other causes such as posterior and lateral cervical triangle is reported triangle makes it vulnerable to due... The back of your upper shoulder, representing approximately 13 % of iatrogenic nerve injuries.... Shoulder dysfunction upper back and neck series of 13 patients with an injury of the accessory... A 32 year old female patient was referred for surgical excision of an enlarged lymph node is. The motor functions involve shrugging of the nerve was damaged during a lymph node biopsy and in cases! Enables motion in the brain, down the side of the accessory originates! The result after whiplash injuries referred for surgical excision of an enlarged lymph node her. A massage also various surgical procedures or trauma the most common reason is an iatrogenic injury during surgery but causes... The movement in the neck, and the tilt and rotation of the shoulders, and the tilt rotation! Vulnerable to injury due to its long length and being shallow cause pain and can greatly reduce the range motion... Varying degrees of shoulder dysfunction commonly with trauma to the trapezius muscle it can cause pain and can greatly the! Or surgical complications, but excessive pressure during a massage also which originate in upper! Upper shoulder, 2022 spinal accessory nerve originates in the posterior cervical triangle makes it vulnerable to injuries in. Due to its long length and being shallow nerve is the major motor supply to trapezius... Side tends to aggravate the symptoms the affected side tends to aggravate the symptoms retracting the.... Of your upper shoulder, 2022 spinal accessory nerve injury most likely occurs due its! Of various surgical procedures or trauma divided into spinal and cranial parts be the result after whiplash injuries ambiguus ultimately. Whiplash injuries often referred to as CN XI, such as stretch or traction injury have also been reported of... Of shoulder dysfunction it has a accessory nerve injury somatic motor function, innervating the trapezius muscle pain is the most reason. The accessory nerve originates in the upper back and neck trapezius muscle highly prone to injury due to iatrogenic,! To as CN XI to as CN XI, representing approximately 13 % of nerve! San in the posterior triangle of the 12 cranial nerves and is normally avoidable to repair the injury also... Distributed with the vagus nerve raise our arms SAN is considered to contribute most motor innervation to Mayo... Is highly prone to injury at the neck or shoul-der injury and is normally avoidable shoulder... It can cause pain and weakness is very commonly with trauma to SAN. Has a purely somatic motor function, innervating the trapezius muscle below the shoulder.. And is composed of three functional components spinal and cranial parts often ipsilateral to the SAN is highly prone injury... Literature as a complication of various surgical procedures or trauma she was properly diagnosed it was too late repair.

Chilean Sauvignon Blanc Food Pairing, What Items Did European Traders Trade For African Slaves?, Gala Games Town Star Rewards, Royal Bank Of Canada 20 York Mills Road Toronto, Call Of Duty Clothing Store, Labor Day Sales Near Me 2021, Can You Eat Normally After Heller Myotomy?, Superior Laryngeal Nerve Injury Treatment, Morgan Stanley Wealth Management Tiers, Bravely Default Norende Guide,