Intraoperative Electromyography for Identification of the Trapezius Muscle Innervation: Clinical Proof of a New Anatomical Concept

Kierner, Antonius C.; Burian, Martin; Bentzien, Sabine; Gstœttner, Wolfgang

doi:10.1097/00005537-200210000-00028

Cited by 47 publications

(44 citation statements)

References 22 publications

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“…The descending part of the trapezius was found to be mainly innervated by the spinal accessory nerve. Astonishingly enough, the transverse and ascending parts of trapezius were reported by Kierner et al [19,20] to receive their motor innervation mainly from the spinal accessory nerve, with only minor contributions from the cervical plexus. Noticeably, damage to the accessory nerve atrophies the trapezius [4,16,21].…”

Section: Discussionmentioning

confidence: 91%

Quantitative Anatomy of the Trapezius Muscle in the Human Fetus

Badura

Grzonkowska

2016

Adv Clin Exp Med

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Section: Discussionmentioning

confidence: 91%

Quantitative Anatomy of the Trapezius Muscle in the Human Fetus

Badura

Grzonkowska

2016

Adv Clin Exp Med

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“…The external branch has the spinal root fibers, it has its own route and moves obliquely downwards and to the back, innervating the trapezium and the sternocleidomastoid muscles. The accessory nerve may be joined by the deep neck plexus of the sternocleidomastoid muscle; however, its motor contributions remain uncertain 8,9 . The shoulder syndrome, resulting from rnd …”

Section: Resultsmentioning

confidence: 99%

Spinal accessory nerve neuropathy following neck dissection

Lima¹,

Amar²,

Lehn³

2011

Braz. j. otorhinolaryngol. (Impr.)

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Tt he most common complication of neck dissection is shoulder dysfunction due to manipulation of spinal accessory nerve, resulting in trapezius muscle atrophy mainly in procedures involving the posterior neck triangle.Aim: This study used electromyography to evaluate the injury to the spinal accessory nerve following neck dissection.Materials and methods: prospective case series of 51 patients submitted to 60 neck dissections followed by physical therapy evaluation of shoulder dysfunction. nerve integrity was evaluated before and after the surgery by means of surface eMG registering the electric activity of the trapezius muscle during voluntary contraction. The patients were grouped according to the type of neck dissection, presence of shoulder pain, impairment during abduction movement and hypotrophy/ atrophy of the trapezius muscle.Results: Action potential had median values of 54.3 microV before surgery and 11.6 microV after it (p<0.001). There was a mean decrease of 70% comparing to preoperative values. The median was 12.5 microV after dissection including level iib, and 8.9 microV after dissection including levels iib and V (p<0.002). Conclusion:Surface eMG is a sensitive and painless method for spinal accessory nerve dysfunction evaluation. The results suggest the usefulness of the trapezius muscle electromyography to confirm diagnosis and early physical therapy intervention in neuropathies of the spinal accessory nerve. Braz J Otorhinolaryngol. 2011;77(2):259-62. ORIgInAL ARTIcLE BJORL

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“…Although most authors agree the spinal accessory nerve provides the trapezius with primary motor innervation, not all agree regarding nerve anatomy. Kiener 26 reported intraoperative electromyography findings revealing a distinct cranial branch of the spinal accessory nerve that separately innervates the upper trapezius. The cervical plexus (C2-C4) also innervates the trapezius providing some motor input in approximately 20% of the population.…”

mentioning

confidence: 99%

Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

Kelley¹,

Kane²,

Leggin³

2008

J Orthop Sports Phys Ther

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signs and symptoms were found related to SANP. A strong relationship appeared between the presence of the scapular flip sign and SANP. The suspected mechanism for the scapular flip sign is the unopposed pull of the humeral external rotators by the inactive middle and lower trapezius. Early identification of SANP can assist with the prognosis, explain persistent impairments and functional deficits, motivate appropriate diagnostic testing and interventions, and help maximize outcome. Further research to validate the scapular flip sign and establish a clinical prediction rule for the diagnosis of SANP should be performed.

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Intraoperative Electromyography for Identification of the Trapezius Muscle Innervation: Clinical Proof of a New Anatomical Concept

Cited by 47 publications

References 22 publications

Quantitative Anatomy of the Trapezius Muscle in the Human Fetus

Quantitative Anatomy of the Trapezius Muscle in the Human Fetus

Spinal accessory nerve neuropathy following neck dissection

Spinal Accessory Nerve Palsy: Associated Signs and Symptoms

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