Intraoperative Fluoroscopic Imaging for Suprascapular Nerve Localization During Spinal Accessory Nerve to Suprascapular Nerve Transfer

Nicole C. Cabbad, Kyle S. Nuland, Aravind Pothula

Research output: Contribution to journalReview article


Distal fiber transfer of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) has been well described as an effective means to regain shoulder external rotation following upper trunk brachial plexus injuries. Both supine and prone positioning techniques have been described with comparable success. Whereas the posterior technique allows for sufficient distal length on the SAN for effective neurotization of the infraclavicular brachial plexus and SSN both proximal and distal to the suprascapular ligament, localization of the SSN within the suprascapular notch can be challenging and time intensive, especially in the obese patient. The use of intraoperative C-arm fluoroscopy is presented as a viable method for more exact suprascapular notch identification during dissection of the SSN.

Original languageEnglish (US)
Pages (from-to)668.e1-668.e5
JournalJournal of Hand Surgery
Issue number8
Publication statusPublished - Aug 1 2017



  • Brachial plexus
  • fluoroscopy
  • nerve transfer
  • peripheral nerve injury
  • surgical technique

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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