Spinal accessory nerve iatrogenic trauma following cervical lymph node biopsy. Treatment by anterior medial antebrachial cutaneous nerve graft: A case report

Abstract

Spinal accessory nerve (SAN) injury often occurs as an iatrogenic nerve injury following posterior cervical lymph node biopsy. Failure to recognize the injury or delayed intervention by hoping that it will resolve with conservative treatment is a usual pitfall. Pain, shoulder drop, scapula instability, asymmetric neckline, and inability to abduct the arm may variably be the symptoms. Direct repair, nerve grafts, nerve conduits, and muscle transfers have been described as treatment options. We report on a case of using a 4.5-cm nerve autograft from the medial antebrachial cutaneous (MABC) nerve branch in order to repair an iatrogenic accessory nerve complete transection following a cervical node biopsy.