{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T22:19:06Z","timestamp":1759961946410},"reference-count":10,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2010,1]]},"abstract":"Object<\/jats:title>The spinal accessory nerve (SAN) has been reported to have a distinctly coiled appearance in its course through the posterior cervical triangle of the neck. As this is unusual compared with other peripheral nerves including the cranial nerves, the present histological analysis was performed to further elucidate the reason for this anatomy with potential application in nerve injury and repair.<\/jats:p><\/jats:sec>Methods<\/jats:title>Ten adult cadavers underwent dissection of the neck. The SAN was harvested proximally and within the posterior cervical triangle. For comparison with other cranial nerves within the neck, the cervical vagus and hypoglossal nerves were also harvested. All nerves underwent histological analysis. Additionally, 2 human fetuses (11 and 20 weeks' gestation) underwent examination of the SAN in the posterior cervical triangle, and 3 randomly selected specimens were submitted for electromicroscopy.<\/jats:p><\/jats:sec>Results<\/jats:title>All SANs were found to have a straight gross configuration proximal to the posterior triangle and a coiled appearance within this geometrical area. Histologically, no differences were identified for the SAN in these 2 locations (that is, proximal to and within the posterior cervical triangle). The histology of the SAN both with routine analysis and electron microscopy was similar in both regions and to nerves used as controls (for example, vagus and hypoglossal nerves). Interestingly, both fetal specimens were found to have coiled SANs in the posterior cervical triangle.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Based on this study, it appears that the tortuous course of the SAN in the posterior triangle arises from functional as opposed to structural forces. It is hoped that this analysis will provide some insight into the nature behind the morphology observed in the SAN within the posterior cervical triangle and aid in future investigations regarding its injury. Moreover, such a coiled nature of this nerve may assist the neurosurgeon in identifying it during, for example, neurotization procedures.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.spine09606","type":"journal-article","created":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T21:56:30Z","timestamp":1262296590000},"page":"22-24","source":"Crossref","is-referenced-by-count":6,"title":["Surgical challenges associated with the morphology of the spinal accessory nerve in the posterior cervical triangle: functional or structural?"],"prefix":"10.3171","volume":"12","author":[{"given":"R. Shane","family":"Tubbs","sequence":"first","affiliation":[{"name":"1Section of Pediatric Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Stetler","sequence":"additional","affiliation":[{"name":"1Section of Pediatric Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert G.","family":"Louis","sequence":"additional","affiliation":[{"name":"2Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia;"},{"name":"3Department of Anatomical Sciences, St. George's University, Grenada and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ankmalika A.","family":"Gupta","sequence":"additional","affiliation":[{"name":"3Department of Anatomical Sciences, St. George's University, Grenada and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marios","family":"Loukas","sequence":"additional","affiliation":[{"name":"3Department of Anatomical Sciences, St. George's University, Grenada and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Kelly","sequence":"additional","affiliation":[{"name":"4Department of Pathology and Laboratory Medicine, Children's Hospital, Birmingham, Alabama;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammadali M.","family":"Shoja","sequence":"additional","affiliation":[{"name":"5Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, and Department of Neurosurgery, Indiana University, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron A.","family":"Cohen-Gadol","sequence":"additional","affiliation":[{"name":"5Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, and Department of Neurosurgery, Indiana University, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-0120022","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1017\/S0022215106000879","volume":"120","author":"Chaukar DA","year":"2006","journal-title":"J Laryngol Otol"},{"key":"b2-0120022","first-page":"256","volume-title":"Gray's Anatomy: The Anatomical Basis of Clinical Practice","author":"Collins P","year":"2005","edition":"39"},{"key":"b3-0120022","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1054\/jhsb.2000.0487","volume":"26","author":"Dailiana ZH","year":"2001","journal-title":"J Hand Surg Br"},{"key":"b4-0120022","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.12.1428"},{"key":"b5-0120022","first-page":"445","volume-title":"Gray's Anatomy: The Anatomical Basis of Clinical Practice","author":"Langdon JD","year":"2005","edition":"39"},{"key":"b6-0120022","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3928\/0147-7447-20020101-20","volume":"25","author":"Lu L","year":"2002","journal-title":"Orthopedics"},{"key":"b7-0120022","first-page":"682","volume":"62","author":"Matz PG","year":"1996","journal-title":"Am Surg"},{"key":"b8-0120022","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/micr.20239","volume":"26","author":"Okajima S","year":"2006","journal-title":"Microsurgery"},{"key":"b9-0120022","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-005-0004-9"},{"key":"b10-0120022","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.3.5.0375"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/12\/1\/article-p22.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/12\/1\/article-p22.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T18:21:57Z","timestamp":1634667717000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/12\/1\/article-p22.xml"}},"subtitle":["Laboratory investigation"],"short-title":[],"issued":{"date-parts":[[2010,1]]},"references-count":10,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2009.7.spine09606","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2010,1]]}}}