Surgical treatment of trapezius palsy: A systematic review

Abstract

Background

Trapezius palsy results from injury to the spinal accessory nerve. The condition presents with loss of shoulder abduction, pain, and winging of the scapula. Surgical treatment may improve functional outcomes and quality of life.

Purpose

The purpose of this study was to report and evaluate the clinical outcomes following surgical management of trapezius palsy.

Study design

Systematic review.

Methods

The electronic databases EMBASE, MEDLINE, and PubMed were searched for studies and relevant data were abstracted. Only studies reporting on outcomes after the surgical treatments of trapezius palsy were included.

Results

A total of 10 studies including 192 patients were included in this review. All surgical interventions resulted in improved function and pain reduction. Patients reported high satisfaction (90–92%) following nerve reconstruction or the Eden–Lange procedure, in comparison to neurolysis. The most common procedure reported was the Eden–Lange muscle transfer (32% reported cases) demonstrating the highest patient satisfaction rates with low complication rate of 7.7%.

Conclusion

Patients failing conservative treatment report good outcomes following surgical treatment of trapezius palsy. All reported surgical procedures demonstrate reduction in pain the best results from the Eden–Lange muscle transfer. Further high-quality comparative studies are required to make definitive conclusions regarding the comparative efficacy of each surgical procedure.

Keywords

trapezius nerve palsy spinal accessory nerve shoulder

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References

Bigliani

Perez-Sanz

Wolfe

. Treatment of trapezius paralysis. J Bone Joint Surg Am 1985; 67A: 871–877.

Fiddian

King

. The winged scapula. Clin Orthop 1984; 185: 228–236.

Hirasawa

Sakakida

. Sports and peripheral nerve injury. Am J Sports Med 1983; 11: 420–426.

Kubota

Ushikubo

Miyata

, et al. Schwannoma of the spinal accessory nerve. J Clin Neurosci 1998; 5: 436–437.

Donner

Kline

. Extracranial spinal accessory nerve injury. Neurosurgery 1993; 32: 907–911.

Eisen

Bertrand

. Isolated accessory nerve palsy of spontaneous origin. Arch Neurol 1972; 27: 496–502.

Van Tuijl

Schmid

Van Kranen-Mastenbroek

, et al. Isolated spinal accessory neuropathy in an adolescent: a case study. Eur J Paed Neurol 2006; 10: 83–85.

Kizilay

Kalcioglu

Saydam

. A new shoulder orthosis for paralysis of the trapezius muscle after radical neck dissection: a preliminary report. Eur Arch Otorhinolaryngol 2006; 263: 477–480.

Salerno

Cavaliere

Foglia

. The 11th nerve syndrome in functional neck dissection. Laryngoscope 2002; 112: 1299–1307.

10.

Gordon

Graham

Black

. Accessory nerve function after surgical procedures in the posterior triangle. Arch Surg 1977; 112: 264–268.

11.

Dvali

Mackinnon

. Nerve repair, grafting, and nerve transfers. Clin Plast Surg 2003; 30: 203–221.

12.

Guo

Zhang

Zou

. Reconstruction of accessory nerve defects with sternocleidomastoid muscle-great auricular nerve flap. Br J Plast Surg 2005; 58: 233–238.

13.

DeLisa JA. Rehabilitation medicine: principles and practice. 2nd ed. Philadelphia, PA: Lippincott, 1993, p.1238.

14.

Higgins

JPT

Green

. Cochrane handbook for systematic reviews of interventions ▪▪. Version 5.1.0 (updated March 2011), The Cochrane Collaboration, 2011, www.handbook.cochrane.org (accessed 10 October 2018).

15.

Moher

Liberati

Tetzlaff

, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009, pp. 6 https://doi.org/10.1371/journal.pmed.1000097 .

16.

Bertelli

Ghizoni

. Combined injury of the accessory nerve and brachial plexus. Neurosurgery 2011; 68: 390–396.

17.

Bertelli

Ghizoni

. Refinements in the technique for repair of the accessory nerve. J Hand Surg Am 2006; 31: 1401–1406.

18.

Bigliani

Compito

Duralde

, et al. Transfer of the levator scapulae, rhomboid major, and rhomboid minor for paralysis of the trapezius. J Bone Joint Surg Am 1996; 78: 1534–1540.

19.

Coessens

Wood

. Levator scapulae transfer and fascia lata fasciodesis for chronic spinal accessory nerve palsy. J Reconstr Microsurg 1995; 11: 277–280.

20.

Chandawarkar

Cervino

Pennington

. Management of iatrogenic injury to the spinal accessory nerve. Plast Reconstr Surg 2003; 111: 611–617.

21.

Elhassan

Wagner

. Outcome of triple-tendon transfer, an Eden–Lange variant, to reconstruct trapezius paralysis. J Shoulder Elbow Surg 2015; 24: 1307–1313.

22.

Göransson

Leppänen

Vastamäki

. Patient outcome after surgical management of the spinal accessory nerve injury: a long-term follow-up study. SAGE Open Med 2016, pp. 4 DOI: 10.1177/2050312116645731.

23.

Krause

. Reinnervation of the trapezius muscle after radical neck dissection. J Cranio Maxilll Surg 1994; 22: 323–329.

24.

Novak

Mackinnon

. Patient outcome after surgical management of an accessory nerve injury. Otolaryngol Head Neck Surg 2002; 127: 221–224.

25.

Romero

Gerber

. Levator scapulae and rhomboid transfer for paralysis of trapezius. J Bone Joint Surg Br 2003; 85: 1141–1145.

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