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The dorsal scapular nerve is at risk for intraoperative injury when detaching the rhomboid and levator scapulae insertions due to its proximity to the medial scapular border. [15] This is of particular concern because the dorsal scapular nerve innervates all three muscles transferred in the Eden–Lange procedure. [citation needed]
Dorsal scapular nerve syndrome can be caused by nerve compression syndrome.A winged scapula is the most common symptom. [7] Shoulder pain may occur. [7] It causes weakness in rhomboid major muscle, rhomboid minor muscle, and levator scapulae muscle. [7]
The levator scapulae is a slender [1]: 910 skeletal muscle situated at the back and side of the neck. It originates from the transverse processes of the four uppermost cervical vertebrae ; it inserts onto the upper portion of the medial border of the scapula .
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.
The scapula plays an important role in shoulder impingement syndrome. [8] It is a wide, flat bone lying on the posterior thoracic wall that provides an attachment for three different groups of muscles. The intrinsic muscles of the scapula include the muscles of the rotator cuff- the subscapularis, infraspinatus, teres minor and supraspinatus. [9]
They are located laterally to the transverse processes between prevertebral muscles from the medial side and vertebral (m. scalenus, m. levator scapulae, m. splenius cervicis) from lateral side. There is anastomosis with accessory nerve, hypoglossal nerve and sympathetic trunk. It is located in the neck, deep to the sternocleidomastoid muscle. [5]
The rhomboid muscles, trapezius, levator scapulae and latissimus dorsi are transected. The neurovascular bundle consisting of the axillary artery, axillary vein and brachial plexus is ligated and cut. The area of the chest left exposed is then normally covered with a split-thickness skin graft. [1]
It also provides motor nerves for the longus capitis, longus colli, anterior scalene, middle scalene, and levator scapulae muscles. [citation needed] C4 contributes some sensory fibers to the supraclavicular nerves, responsible for sensation from the skin above the clavicle. [1]