Lesioni iatrogene del nervo accessorio spinale: responsabilità professionale,rischio del medico e aspetti giuridici

Abstract

The majority of lesions of the spinal accessory nerve occur as an iatrogenic injury after lymph node biopsy in the posterior cervical triangle. In most cases the accessory nerve palsy is not recognised immediately after the injury. Therefore surgical repair is often performed too late to regain sufficient function of the paralytic trapezium muscle. We report a case of a 23 year old patient who was taken in Hospital for a non Hodgkin’s lymphoma. After biopsy a strong pain to right shoulder emerged. Despite the man’s complaints of left arm weakness the doctor waited several weeks to look into the matter. Only one year later he was properly diagnosed with a iatrogenic accessory nerve injury. The iatrogenic injuries of the accessory nerve may lead to significant lifelong disability. The diagnosis is not always made in time with consequent delay in repair may be regarded as an unfavourable issue during medical-legal discussions. The Author recommends in interest to prevent nerve injury in the posterior triangle of the neck to perform operation in special department.