ABSTRACT
Spinal accessory nerve sections due to a purely traumatic origin are very rare. The
authors report a case in which a total section of the spinal accessory nerve was observed
after a glass-penetrating injury. The primary lesion was undiagnosed, and only late
physical examination revealed a scapula alata with a deficiency in shoulder protrusion
and elevation. Surgical exploration with direct suturing of the nerve was performed
2 months after the initial trauma; full restoration of muscle function was obtained
12 months after the surgical procedure. Pain, the dominant preoperative feature, totally
disappeared after restoration of shoulder function. Although infrequent, spinal accessory
nerve lesions must always be excluded in cases of penetrating injuries in the posterior
triangle of the neck. Emphasis is placed on diagnosis and treatment of this condition.