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Timely intervention can restore function following iatrogenic spine access nerve injuries
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Findings of this study indicated efficient surgical intervention of iatrogenic spine access nerve injuries can help restore diminished or absent function and highlighted the risk of sustaining these injuries during lymph node biopsies performed in zone 1 of the posterior cervical triangle.
Researchers conducted a retrospective study of their experiences with 156 patients who sustained iatrogenic spine access nerve (SAN) injuries during cervical lymph node biopsies performed at their institution between 1980 and 2012. Overall, 154 patients sustained the injury during a biopsy in zone 1 of the posterior cervical triangle. Each patient underwent a thorough clinical assessment for SAN motor function pre- and post-repair.
Using the Louisiana State University Health Science Center grading system, investigators found 87% of the 123 patients who underwent graft or suture repair improved to grade 3 functionality or higher. In 29 patients, surgeons found the nerve was in continuity with recordable nerve action potential across the lesion and neurolysis was performed. Of these patients, more than 95% improved to grade 3 or higher.
End-to-end repair was performed in 41 patients, and 90% of these patients improved to grade 3 or higher. In addition, 82 patients underwent graft repair. Of the graft repair patients, 85% improved to grade 3 or higher.
Researchers concluded surgical exploration is indicated for SAN injury patients who do not exhibit electric or clinical signs of improvement at 3 months post injury. – by Robert Linnehan.
Disclosures: The researchers report no relevant financial disclosures.
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