Shoulder Weakness after Surgery
Definition and Diagnosis
Secondary to stretching or direct surgical irritation of the nerves that control shoulder function, patients may occasionally have shoulder paralysis after surgery (e.g., cervical disc surgery). Although uncertain, the cause may be stretching of the upper brachial plexus during patient positioning on the operating room table. Considering most patients are positioned the same, an as yet unknown predisposition in affected patients may be present. Diagnosis is made with a history and physical examination. Electrical testing is useful for determining prognosis, but is not always required.
Fortunately, the majority of patients recover spontaneously in 6-12 months. During this time, physical therapy is prescribed for range of motion and strengthening. Although rarely indicated, if there is no clinical or electrical evidence of recovery at 6 months, select nerve transfers to re-animate the shoulder may be an option. Therefore, all patients should be evaluated early and followed by a physician with expertise in nerve injury.