Spinal Accessory Nerve Injury Induced by Manipulation Therapy: A Case Report – Full Text Article

Case Report

Annals of Rehabilitation Medicine 2018;42(5):773-776.

Published online: October 31, 2018

DOI: https://doi.org/10.5535/arm.2018.42.5.773

Jung Ro Yoon, MD, Yong Ki Kim, MD, Yun Dam Ko, MD, Soo In Yun, MD, Dae Heon Song, MD, PhD, Myung Eun Chung, MD, PhD
Department of Rehabilitation Medicine, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Corresponding author: Myung Eun Chung Department of Rehabilitation Medicine, St. Paul’s Hospital, College of Medicine, The Catholic University of Korea, 180 Wangsan-ro, Dongdaemun-gu, Seoul 02559, Korea. Tel: +82-2-958-2307, Fax: +82-2-968-2307, E-mail: coltrane@catholic.ac.kr
Received September 6, 2017 Accepted December 11, 2017

Copyright © 2018 by Korean Academy of Rehabilitation Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Spinal accessory nerve (SAN) injury mostly occurs during surgical procedures. SAN injury caused by manipulation therapy has been rarely reported. We present a rare case of SAN injury associated with manipulation therapy showing scapular winging and droopy shoulder. A 42-year-old woman visited our outpatient clinic complaining of pain and limited active range of motion (ROM) in right shoulder and scapular winging after manipulation therapy. Needle electromyography and nerve conduction study suggested SAN injury. Physical therapy (PT) three times a week for 2 weeks were prescribed. After a total of 6 sessions of PT and modality, the patient reported that the pain was gradually relieved during shoulder flexion and abduction with improved active ROM of shoulder. Over the course of 2 months follow-up, the patient reported almost recovered shoulder ROM and strength as before. She did not complain of shoulder pain any more.

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