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There are several options of treatment when iatrogenic (i.e., caused by the surgeon) spinal accessory nerve damage is noted during surgery. For example, during a functional neck dissection that injures the spinal accessory nerve, injury prompts the surgeon to cautiously preserve branches of C2, C3, and C4 spinal nerves that provide supplemental innervation to the trapezius muscle. [3]
Injury to the accessory nerve can result in neck pain and weakness of the trapezius muscle. Symptoms will depend on at what point along its length the nerve was severed. [5] Injury to the nerve can result in shoulder girdle depression, atrophy, abnormal movement, a protruding scapula, and weakened abduction. [5]
An example of trapezius function is an overhead press. When activating together, the upper and lower fibers also assist the middle fibers (along with other muscles such as the rhomboids) with scapular retraction/adduction. The trapezius also assists in abduction of the shoulder above 90 degrees by rotating the glenoid upward.
The second category is the lateral winging which is caused by injury of the spinal accessory nerve. Severe atrophy of the trapezius is seen with accidental damage to the spinal accessory nerve during lymph node biopsy of the neck. There are numerous ways in which the long thoracic nerve can sustain trauma-induced injury.
Damage to the accessory nerve (XI) will lead to weakness in the trapezius muscle on the same side as the damage. The trapezius lifts the shoulder when shrugging , so the affected shoulder will not be able to shrug and the shoulder blade ( scapula ) will protrude into a winged position. [ 3 ]
Damage results in an inability to shrug the shoulders or raise the arm above the head, particularly due to compromised trapezius muscle innervation. The external jugular vein's superficial location within the posterior triangle also makes it vulnerable to injury.
A self-limiting spontaneously occurring form of torticollis with one or more painful neck muscles is by far the most common ('stiff neck') and will pass spontaneously in 1–4 weeks. Usually the sternocleidomastoid muscle or the trapezius muscle is involved. Sometimes draughts, colds, or unusual postures are implicated; however, in many cases ...
A 1000-case, four-year observational study published in 2012 said that the "missing link" in whiplash injuries is the trapezius muscle which may be damaged through eccentric muscle contraction during the whiplash mechanism described above and below. [12]