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Báo cáo y học: "Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve; results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash . | Nystrom et al. Journal of Brachial Plexus and Peripheral Nerve Injury 2010 5 7 http www.jbppni.eom content 5 1 7 JOURNAL OF BRACHIAL PLEXUS AND PERIPHERAL NERVE INJURY RESEARCH ARTICLE Open Access Surgical fasciectomy of the trapezius muscle combined with neurolysis of the Spinal accessory nerve results and long-term follow-up in 30 consecutive cases of refractory chronic whiplash syndrome N Ake Nystrom 1 2 Lloyd P Champagne3 Michael Freeman4 and Elisabet Blix5 Abstract Background Chronic problems from whiplash trauma generally include headache pain and neck stiffness that may prove refractory to conservative treatment modalities. As has previously been reported such afflicted patients may experience significant temporary relief with injections of local anesthetic to painful trigger points in muscles of the shoulder and neck or lasting symptomatic improvement through surgical excision of myofascial trigger points. In a subset of patients who present with chronic whiplash syndrome the clinical findings suggest an affliction of the spinal accessory nerve CN XI SAN by entrapment under the fascia of the trapezius muscle. The present study was undertaken to assess the effectiveness of SAN neurolysis in chronic whiplash syndrome. Methods A standardized questionnaire and a linear visual-analogue scale graded 0-10 was used to assess disability related to five symptoms pain headache insomnia weakness and stiffness before and one year after surgery in a series of thirty consecutive patients. Results The preoperative duration of symptoms ranged from seven months to 13 years. The following changes in disability scores were documented one year after surgery Overall pain decreased from 9.5 - 0.9 to 3.2 - 2.6 p 0.001 headaches from 8.2 - 2.9 to 2.3 - 2.8 p 0.001 insomnia from 7.5 - 2.4 to 3.8 - 2.8 p 0.001 weakness from 7.6 - 2.6 to 3.6 - 2.8 p 0.001 and stiffness from 7.0 - 3.2 to 2.6 - 2.7 p 0.001 . Conclusions Entrapment of the spinal accessory nerve and or chronic compartment