Functional restoration of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization utilizing the functional spinal accessory nerve

2011 ◽  
Vol 15 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Ming-liang Yang ◽  
Jian-jun Li ◽  
Shao-cheng Zhang ◽  
Liang-jie Du ◽  
Feng Gao ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Functional Restoration ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Functional Improvement ◽  
Function Evaluation ◽  
Spinal Accessory ◽  
Cord Injury ◽  
The Right ◽  
High Cervical

The authors report a case of functional improvement of the paralyzed diaphragm in high cervical quadriplegia via phrenic nerve neurotization using a functional spinal accessory nerve. Complete spinal cord injury at the C-2 level was diagnosed in a 44-year-old man. Left diaphragm activity was decreased, and the right diaphragm was completely paralyzed. When the level of metabolism or activity (for example, fever, sitting, or speech) slightly increased, dyspnea occurred. The patient underwent neurotization of the right phrenic nerve with the trapezius branch of the right spinal accessory nerve at 11 months postinjury. Four weeks after surgery, training of the synchronous activities of the trapezius muscle and inspiration was conducted. Six months after surgery, motion was observed in the previously paralyzed right diaphragm. The lung function evaluation indicated improvements in vital capacity and tidal volume. This patient was able to sit in a wheelchair and conduct outdoor activities without assisted ventilation 12 months after surgery.

Phrenic nerve neurotization utilizing half of the spinal accessory nerve to the functional restoration of the paralyzed diaphragm in high spinal cord injury secondary to brain tumor resection

2020 ◽  
Vol 36 (6) ◽  
pp. 1307-1310
Author(s):  
Antonio Heredia Gutiérrez ◽  
Gabriel Emmanuel Cachón Cámara ◽  
Vicente González Carranza ◽  
Samuel Torres García ◽  
Fernando Chico Ponce de León
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Tumor ◽  
Phrenic Nerve ◽  
Tumor Resection ◽  
Functional Restoration ◽  
Spinal Accessory Nerve ◽  
Spinal Accessory ◽  
Cord Injury ◽  
Brain Tumor Resection

Phrenic nerve neurotization utilizing the spinal accessory nerve: technical note with potential application in patients with high cervical quadriplegia

2008 ◽  
Vol 24 (11) ◽  
pp. 1341-1344 ◽  
Author(s):  
R. Shane Tubbs ◽  
Blake Pearson ◽  
Marios Loukas ◽  
Ghaffar Shokouhi ◽  
Mohammadali M. Shoja ◽  
...  
Keyword(s):  
Phrenic Nerve ◽  
Potential Application ◽  
Technical Note ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Spinal Accessory ◽  
High Cervical

Properties of spinal accessory nerve activity response to changes in chemical drive

1983 ◽  
Vol 55 (1) ◽  
pp. 164-168 ◽  
Author(s):  
T. Nishino ◽  
T. Yonezawa ◽  
Y. Honda
Keyword(s):  
Phrenic Nerve ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Nerve Activity ◽  
Arterial Pco2 ◽  
Spinal Accessory ◽  
Activity Response ◽  
Low Levels ◽  
Electrical Activities ◽  
Arterial Po2

In anesthetized, vagotomized, and artificially ventilated cats, the electrical activities of the spinal accessory nerve (SAN) and the phrenic nerve (PN) were simultaneously recorded and comparison between the responses of the SAN and the PN to changes in chemical drive was made. Hypercapnia and hypoxia increased SAN activity as well as PN activity, but the SAN had a greater increase in activity than the PN at high levels of arterial Pco2 and at low levels of arterial Po2. Also, doxapram injection increased SAN activity more than PN activity. Following hypocapnic apnea, the reinitiation of PN activity always preceded that of the SAN, indicating that threshold arterial Pco2 for the SAN was higher than for the PN. Thus the responses of SAN activity to changes in chemical drive are qualitatively similar but quantitatively different from those of the PN.

scholarly journals The Relation of the Extracranial Spinal Accessory Nerve to the Sternocleidomastoid Muscle and the Internal Jugular Vein

2019 ◽  
Vol 12 (2) ◽  
pp. 108-111 ◽  
Author(s):  
ThomasMombo Amuti ◽  
Fawzia Butt ◽  
BedaOlabu Otieno ◽  
JuliusAlexander Ogeng'o
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Sternocleidomastoid Muscle ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Mastoid Process ◽  
Spinal Accessory ◽  
Posterior Triangle ◽  
Point Of Entry ◽  
The Right

The spinal accessory nerve (SAN) exhibits variant anatomy in its relation to the internal jugular vein (IJV) as well as the sternocleidomastoid muscle (SCM). These variations are important in locating the nerve during surgical neck procedures to avoid its inadvertent injury. These variations, however, are not conserved among different populations and data from the Kenyan setting are partly elucidated. This study, therefore, aims to determine the variant anatomical relationship of the SAN to the SCM and IJV in a select Kenyan population. Forty cadaveric necks were studied bilaterally during routine dissection and the data collected were analyzed using SPSS version 21. Means and modes were calculated for the point of entry of the SAN into the posterior triangle of the neck as well as for its relation to the SCM. Side variations for both of these were analyzed using Student's t-test. Data relating the SAN to the IJV were represented in percentages and side variations were analyzed using the chi-square test. The SAN point of entry into the posterior triangle of the neck was 5.38 cm (3.501–8.008 cm) on the left side and 5.637 cm (3.504–9.173 cm) on the right side ( p = 0.785) from the mastoid process. The nerve perforated the SCM in four cases (10%) on the left side and in eight cases (20%) on the right ( p = 0.253). The SAN lay predominantly medial to the IJV on both sides of the neck, 87.5% on the left side of the neck versus 82.5% on the right ( p = 0.831). In conclusion, the variant relation of the SAN to the IJV and SCM as observed in this setting is an important consideration during radical neck procedures and node biopsies.

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