title: Delayed primary repair of a kyrogenic spinal accessory nerve injury: a case report.
abstract: The course of the accessory nerve through the posterior cervical triangle is superficial and in close juxtaposition to the posterior cervical lymph node chain. These anatomic features contribute to the common occurrence of kyrogenic injury to the accessory nerve. Unfortunately, the diagnosis of this injury often is delayed because the clinical presentation may mimic shoulder impingement or adhesive capsulitis. The authors present a case with a 15-year followup of a 48-year-old woman who underwent successful delayed primary repair of an accessory nerve injury after a lymph node biopsy. Electromyographic examination is recommended at 3 weeks after a suspected accessory nerve lesion, and if evidence of trapezial denervation is present, early surgical exploration is indicated because spontaneous recovery is rare.
authors.affiliation: Shoulder Service of the Department of Orthopaedics, The University of Texas Health Science Center at San Antonio 78284-7774, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Jensen
authors.forename: C A
authors.initials: CA
authors.lastname: Rockwood
mesh_terms: D061227:Accessory Nerve Injuries; D001706:Biopsy; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000601:surgery; D004576:Electromyography; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D013997:Time Factors