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Spinal Accessory Nerve Injury

What is the spinal accessory nerve?

The spinal accessory nerve is the eleventh of twelve cranial nerves, which originate in the brain. This nerve innervates the trapezius and sternomastoid muscles in the neck. The sternomastoid muscle allows the head to tilt and rotate. The trapezius muscle allows for several motions, such as shrugging the shoulder or adduction of the scapula.

Causes of spinal accessory nerve injury

A spinal accessory nerve injury can be caused by trauma or damage during surgery, such as a lymph node biopsy or jugular vein cannulation.

Symptoms of spinal accessory nerve injury

Symptoms of peroneal nerve injury (foot drop) may include:

  • Shoulder pain
  • Scapular winging
  • Weakness or atrophy of the trapezius muscle

Diagnosis of spinal accessory nerve injury

Proper diagnosis of a spinal accessory nerve injury requires the expert attention of experienced neurologists and nerve specialists.

Diagnosis will include:

  • A comprehensive clinical exam, including neurological exams
  • Complete medical history
  • Electrical testing

Diagnosis is necessary to determine the cause of the spinal accessory nerve injury, so the appropriate treatment plan, including a surgical option, is considered.

Treatment for spinal accessory nerve injury

Treatment for spinal accessory nerve injuries may need to be performed immediately upon discovery, or within 3-6 months of the injury, if severe in nature.

Nonsurgical treatment for spinal accessory nerve injury

Physical therapy is the main component of treatment for a spinal accessory nerve injury, including post-surgery.

Surgery for spinal accessory nerve injury

Depending on the severity and cause of the injury, one of several surgical options may be recommended, including:

  • Nerve surgery
  • Nerve grafting
  • Nerve regeneration

For patients who are not candidates for nerve surgery, other options such as tendon or muscle transfer may be recommended to stabilize the scapula and neck muscles.

Dr. Allan Belzberg is a world-renowned neurosurgeon in the treatment of peripheral nerve injuries. He treats on average 500 nerve injuries every year and has published research publications focusing on improving surgical repairs of nerve injuries and discovering new treatment options. Catch up on the latest research on nerve injuries.

To make an appointment or request a consultation, contact the Johns Hopkins Peripheral Nerve Surgery Center at 410-614-9923.

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Maryland Patients

To request an appointment or refer a patient, please contact the Johns Hopkins Peripheral Nerve Surgery Center at 410-614-9923.
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Adult Neurology: 410-955-9441
Pediatric Neurology: 410-955-4259
Adult Neurosurgery: 410-955-6406
Pediatric Neurosurgery: 410-955-7337



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