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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

Iatrogenic lesions of the spinal accessory nerve

Management iatrogener N.-accessorius-Läsionen

Meeting Abstract

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  • corresponding author Ute Marlies Bäzner - Neurochirurgische Abteilung der Universität Ulm,Günzburg
  • G. Antoniadis - Neurochirurgische Abteilung der Universität Ulm,Günzburg
  • V. Braun - Neurochirurgische Abteilung der Universität Ulm,Günzburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocDI.05.08

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0198.shtml

Veröffentlicht: 23. April 2004

© 2004 Bäzner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Evaluation of the causes of iatrogenic injuries of the spinal accessory nerve and the presentation of the results after neurosurgical repair.

Methods

From 1994 to 2003, 30 patients were operated on in our department for iatrogenic lesions of the XI. cranial nerve. 21/30 patients underwent a previous lymph node exstirpation, 2/30 were injured during a selective peripheral denervation for spasmodic torticollis, the other 7 patients by different causes. The neurosurgical intervention was performed 0-19 months post-traumatically (mean, 7.2 months). All patients showed a paresis/ atrophy of the trapezius muscle, the abduction of the shoulder was markly reduced. Additional neck and/or shoulder pain was present in 28/30 cases. In 7 cases, the nerve was compressed by scar tissue and subsequently treated by external neurolysis. 10 patients underwent an end-to-end anastomosis; an autologous sural nerve grafting was necessary in 13 cases.

Results

After a mean follow-up of 12.6 months a complete recovery was found in 7/30 patients. 19/30 patients showed a partial relief of pain and weakness. Only 4 patients remained unchanged. The clinical findings after autologous nerve grafting, end-to-end reconstruction or external neurolysis did not show any significant difference.

Conclusions

Microsurgical reconstruction of an iatrogenic injury of the spinal accessory nerve is very promissing if the interval between trauma and surgical revision is less than 6 months. Up to 12 months, a partial recovery can be achieved, a longer delay will normally result in a bad outcome.