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Review
. 2020 Jun;12(3):153-162.
doi: 10.1177/1758573219872730. Epub 2019 Sep 9.

Surgical treatment of trapezius palsy: A systematic review

Rawaan S Elsawi  1 , Seline Y Vancolen  1 , Nolan S Horner  1 , Moin Khan  1 , Bashar Alolabi  1
Affiliations
Review

Surgical treatment of trapezius palsy: A systematic review

Rawaan S Elsawi et al. Shoulder Elbow. 2020 Jun.

Abstract

Background: Trapezius palsy results from injury to the spinal accessory nerve. The condition presents with loss of shoulder abduction, pain, and winging of the scapula. Surgical treatment may improve functional outcomes and quality of life.

Purpose: The purpose of this study was to report and evaluate the clinical outcomes following surgical management of trapezius palsy.

Study design: Systematic review.

Methods: The electronic databases EMBASE, MEDLINE, and PubMed were searched for studies and relevant data were abstracted. Only studies reporting on outcomes after the surgical treatments of trapezius palsy were included.

Results: A total of 10 studies including 192 patients were included in this review. All surgical interventions resulted in improved function and pain reduction. Patients reported high satisfaction (90-92%) following nerve reconstruction or the Eden-Lange procedure, in comparison to neurolysis. The most common procedure reported was the Eden-Lange muscle transfer (32% reported cases) demonstrating the highest patient satisfaction rates with low complication rate of 7.7%.

Conclusion: Patients failing conservative treatment report good outcomes following surgical treatment of trapezius palsy. All reported surgical procedures demonstrate reduction in pain the best results from the Eden-Lange muscle transfer. Further high-quality comparative studies are required to make definitive conclusions regarding the comparative efficacy of each surgical procedure.

Keywords: shoulder; spinal accessory nerve; trapezius nerve palsy.

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Figures

Figure 1.
Figure 1.
Eden–Lange procedure diagram. In the Eden–Lange procedure, the elevator scapulae muscle is released and transferred to the lateral aspect of the scapula. The rhomboid major and minor are transferred medially to the infraspinatus fossa (classic technique) or the rhomboid major to the infraspinatus fossa and rhomboid minor to the supraspinatus fossa (modified eden–lange). Following these steps, the trapezius muscle is reattached to the scapula. The muscular attachments before (a) and after (b) the Eden–Lange procedure are also shown.
Figure 2.
Figure 2.
Flowchart of results.
See this image and copyright information in PMC

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