Anterior interosseous nerve neuropathy in a patient with spinal cord injury: case report and literature review

Abstract

Introduction: Entrapment neuropathies, typically carpal tunnel syndrome and ulnar neuropathy, frequently occur in patients with spinal cord injury (SCI). Upper limb impairments due to entrapment neuropathy can be particularly debilitating in this population. Anterior interosseous nerve (AIN) neuropathy has not been previously described in the SCI population. Case presentation: A 27-year-old left-handed man with a history of C7 ASIA Impairment Scale B spinal cord injury five years prior presented to clinic with decreased left thumb function as well as thumb flexion. Workup including nerve conduction studies, electromyogram, ultrasonographic assessment, and magnetic resonance neurography was consistent with compressive AIN neuropathy. Surgical exploration and neurolysis was performed, with improvement of symptoms. Discussion: Entrapment neuropathies should be carefully considered in the evaluation of patients with SCI with new motor deficits. We report a case of AIN neuropathy in a patient with SCI successfully treated with surgical decompression, and review the literature describing upper extremity entrapment neuropathies in this population. Surgical decompression is an effective option for treatment of AIN neuropathy in the setting of SCI, though further characterization of the optimal management strategy is needed.