ABSTRACT
Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.
Subject(s)
Adult , Female , Humans , Accessory Nerve Injuries , Accessory Nerve , Ambulatory Care Facilities , Electromyography , Follow-Up Studies , Musculoskeletal Manipulations , Needles , Neural Conduction , Range of Motion, Articular , Shoulder , Shoulder PainABSTRACT
<p><b>OBJECTIVE</b>To describe a new method of accessory nerve defect reconstruction with sternocleidomastoid muscle-great auricular flap.</p><p><b>METHODS</b>Thirty-four cases receiving traditional radical neck dissection were divided into two groups: single neck dissection group (n = 19) and accessory nerve reconstruction group (n = 15). Surgical procedure of the reconstruction was described in detail. Postoperative shoulder functions were compared between the two groups.</p><p><b>RESULTS</b>Accessory nerve reconstruction group experienced much better shoulder function recovery than that in single neck dissection group.</p><p><b>CONCLUSIONS</b>Reconstruction of accessory nerve defects with sternocleidomastoid muscle-great auricular nerve flap is simple, effective and complication-free.</p>