1996•Hand SurgeryRequires access
THE ACCESSORY NERVE AND THE CERVICAL PLEXUS: ANATOMY AND CLINICAL IMPLICATIONS
V. Wu, Ying-lee Lam, Yun-po Chang, Kai-Chung Poon, Kin-Ming Au
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Abstract
The accessory nerve and the motor branch of the cervical plexus have been used as donor nerves in neurotisation procedures for brachial plexus palsy. However, there are few reports in the literature that describe their anatomy in detail. The aim of this study is to delineate the applied anatomy of these nerves. We emphasise their course in the posterior triangle of the neck as well as within the trapezius muscle. Fourteen cadavers were dissected. We identified nerves not reported before and they are the lateral cutaneous branches of C3 and C4. The deep branch of C4 is present in all the cases; it supplies the trapezius muscle and we believe it contains motor fibres. The accessory nerve gives a branch in the neck in only one case. The accessory nerve joins the deep branch of C4 in 93.3% of the cases. Clinical implications of the findings would be discussed.