What is included in preoperative management of a spinal accessory nerve (SAN) injury?

Updated: Feb 09, 2018
  • Author: Rohan R Walvekar, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

As discussed above, rapid diagnosis and management of SAN injury is critical because surgical outcomes are dependent on the time that elapses from the initial onset of symptoms or nerve injury to surgical therapy. Physical therapy is always recommended to maintain passive range of motion (ROM) about the shoulder joint and prevent adhesive capsulitis. Surgery is indicated if serial clinical examinations as well as electromyelography (EMG) do not demonstrate SAN function. Electrodiagnostic testing at 12 weeks after onset of SAN injury will show recovering function if the nerve is simply neurapraxic rather than transected. [53] If SAN injury is discovered at the time of the initial operation, immediate surgical repair is recommended.


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