A Case of Spinal Accessory Neuropathy Caused by a Neck Strap Compression

J Korean Assoc EMG Electrodiagn Med 2007;9(2):171-175.
Published online May 10, 2007.

Abstract

The spinal accessory nerve passes through the posterior cervical triangle at the mid-point of the posterior border of the sternocleidomastoid and passes beneath the trapezius attached to the lower surface of the muscle as it descends. It is very superficial and thus vulnerable to injury. Iatrogenic injury to the nerve after a surgical procedure is one of the leading causes of trapezius paralysis. During sports activity it may be damaged by direct and penetrating trauma to the neck. Indirect traction injuries to the upper extremity from blunt trauma and dislocation of the sternoclavicular & acrominoclavicular joints may cause trapezius palsies. Extended use of an arm sling can also compress the nerve. We experienced a case of spinal accessory neuropathy caused by a neck strap used when playing the alto saxophone.

Key Words: Spinal accessory nerve, Compression, Winged scapula