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Acta Neurochirurgica
Erschienen in: Acta Neurochirurgica 12/2015

01.12.2015 | Technical Note - Neurosurgical Techniques

Transdiscal C6–C7 contralateral C7 nerve root transfer in the surgical repair of brachial plexus avulsion injuries

verfasst von: Vicente Vanaclocha, Juan Manuel Herrera, Francisco Verdu-Lopez, Laurabel Gozalbes, Moises Sanchez-Pardo, Marlon Rivera, Deborah Martinez-Gomez, Juan D. Mayorga

Erschienen in: Acta Neurochirurgica | Ausgabe 12/2015

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Abstract

Background

Repair of complete brachial plexus avulsion injuries may require contralateral C7 nerve root transfer. The available techniques might allow direct neuroraphy in about 50 % of cases but the others require interposing nerve grafts or humeral shaft shortening. We aimed to see if transdiscal C6–C7 contralateral C7 nerve root transfer is technically feasible and if it allows direct coaptation with the contralateral nerve roots in 100 % of cases.

Methods

In ten fresh-frozen adult cadavers, the C7 nerve root was sectioned just before it connects with other brachial plexus branches and re-routed though the C6–C7 disc space to the contralateral side. A complete C6–C7 discectomy was performed and the disc space kept open with the aid of an autologous iliac crest bone graft.

Results

Transdiscal C6–C7 contralateral C7 nerve root transfer is technically feasible. In our cadavers, it provided 5.3 ± 1.2 SDcm of extra length that allowed direct coaptation with the contralateral nerve roots, mainly C8 and T1.

Conclusions

Transdiscal C6–C7 contralateral C7 nerve root transfer is technically feasible. In our dissections it lengthens the available C7 nerve root stump by 5.3 ± 1.2SDcm. The increase was 4 cm versus the retropharyngeal route making direct coaptation with the contralateral C8 and T1 nerve roots possible.
Literatur
1.
Ali Z, Meyer RA, Belzberg AJ (2002) Neuropathic pain after C7 spinal nerve transection in man. Pain 96(1–2):41–47CrossRefPubMed
2.
Bertelli JA, Ghizoni MF (2004) Contralateral and ipsilateral nerve rootlets engine in brachial plexus reconstruction transfers. J Neurosurg 101(5):770–778CrossRefPubMed
3.
Birch R, Dunkerton M, Bonney G, Jamieson PM (1988) Experience with the free vascularized ulnar nerve graft in repair of supraclavicular lesion of the brachial plexus. Clin Orthop Relat Res 237:96–104PubMed
4.
Bonnel F (1984) Microscopic anatomy of the adult human brachial plexus: an anatomical and histological basis for microsurgery. Microsurgery 5:107–110CrossRefPubMed
5.
Bosmia AN, Hogan E, Loukas MR, Tubbs S, Cohen-Gadol A (2015) Blood supply to the human spinal cord. I. Anatomy and hemodynamics. Clin Anat 28(1):52–64CrossRefPubMed
6.
Chakravorty BG (1971) Arterial supply of the cervical spinal cord (with special reference to the radicular arteries). Anat Rec 170(3):311–29CrossRefPubMed
7.
Chen L, Go YD, Hu SN, Xu JG, Xu L, Fu Y (2007) Contralateral C7 transfer for the treatment of brachial plexus root avulsion in children: a report of 12 cases. Am J Hand Surg 32(1):96–103CrossRef
8.
Chuang DC, Wei FC, Noordhoff MS (1992) Cross-chest C7 nerve grafting followed by free muscle transplantation for the treatment of total avulsed brachial plexus injuries: a preliminary report. Plast Reconstr Surg 92:717–725CrossRef
9.
Chuang DC (1995) Brachial plexus neurotization. Procedures for injuries. Hand Clin 11(4):633–645PubMed
10.
Epstein NE (2012) Iliac crest autograft versus alternative constructs for anterior cervical spine surgery: pros, cons, and costs. SNI Spine 3(Suppl 3A):S143–S156
11.
Feng J, Wang T, Gu Y, Chen L, Zang G, Zhu Y (2010) Contralateral C7 transfer to lower trunk via a subcutaneous tunnel across the anterior surface of chest and neck for total root avulsion of the brachial plexus: a preliminary report. Neurosurgery 66(Suppl 2):252–263PubMed
12.
Gu YD, Chen DS, Zhang GM, Cheng XM, Xu JG, Zhang LY, Cai PQ, Chen L (1998) Long-term functional results of contralateral C7 transfer. J Reconstr Microsurg 14:57–59CrossRefPubMed
13.
Gu YD, Zhang G, Chen DS, Yan JG, Cheng XM, Chen L (1991) Cervical nerve root transfer from contralateral normal side for treatment of brachial plexus nerve root avulsions. Chin Med J 104:208–211PubMed
14.
Gu YD, Zhang GM, Chen DS, Yan JG, Cheng XM, Chen L (1992) Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion. Br J Hand Surg 17(5):518–521CrossRef
15.
Gu YD, Xu J, Chen L, Wang H, Hu S (2002) Long-term outcome of contralateral C7 transfer: a report of 32 cases. Chin Med J (Engl) 115(6):866–868
16.
Gu YD (2007) Contralateral C7 root transfer over the last 20 years in China. Chin Med J (Engl) 120(13):1123–1126
17.
Li W, Wang SF, Zhao J, Rahman MF, Li Y, Li P, Xue Y (2014) Complications of contralateral C7 transfer through the modified prespinal route for repairing brachial plexus root avulsion injury: a retrospective study of 425 patients. J Neurosurg 12:1–8
18.
Lin HD, Hou CL, Chen AM, Xu Z (2011) Transfer of the phrenic nerve to the posterior division of the lower trunk to recover thumb and finger extension in brachial plexus palsy. J Neurosurg 114(1):212–216CrossRefPubMed
19.
Mcguiness CN, Kay SP (2002) The pre-lateral spinal route in counter C7 nerve root transfer for brachial plexus avulsion injuries. J Hand Surg (Br) 27(2):159–160CrossRef
20.
Midha R (2004) Nerve transfers for severe brachial plexus injuries: a review. Neurosurg Focus 16(5):1–10CrossRef
21.
Poynton AR, Lane JM (2002) Safety profile for the clinical use of bone morphogenetic proteins in the spine. Spine 27(16S):S40–S48CrossRefPubMed
22.
Sammer DM, Kirher MF, Bishop AT, Spinner RJ, Shin AY (2012) Hemi-contralateral C7 transfer in traumatic brachial plexus injuries: outcomes and complications. J Bone Joint Surg 94(2):131–137CrossRefPubMed
23.
Songcharoen P, Wongtrakul S, Mahaisavariya B, Spinner RJ (2001) Hemi-contralateral C7 transfer to median nerve in the treatment of brachial plexus root avulsion injury. J Hand Surg [Am] 26(6):1058–1064CrossRef
24.
Terzis JK, Kokkalis ZT (2009) Selective contralateral C7 transfer in posttraumatic brachial plexus injury: a report of 56 cases. Plast Reconst Surg 123(3):927–938CrossRefPubMed
25.
Turnbull JM, Breig A, Hassler O (1966) Blood supply of the cervical spinal cord in man. A microangiographic cadaver study. J Neurosurg 24:951–965CrossRefPubMed
26.
Waikakul S, Orapin S, Vanadurongwan V (1999) Clinical results of contralateral C7 root neurotization to the median nerve in brachial plexus root avulsions total injuries. Br J Hand Surg 16(24):556–560CrossRef
27.
Wang S, Yiu HW, Li P, Li Y, Wang H, Pan Y (2012) Contralateral C7 nerve root transfer to neurotize the upper trunk via a modified prespinal route in repair of brachial plexus avulsion injury. Microsurgery 32:183–188CrossRefPubMed
28.
Wang SF, Li PC, Xue PY, Yiu YW, Li YC, Wang HH (2013) Contralateral C7 transfer with direct coaptation to restore function after traumatic lower trunk brachial plexus avulsion. J Bone Joint Surg Am 95(9):821–827CrossRefPubMed
29.
Weber RV, Mackinnon SE (2004) Nerve transfers in the upper extremity. J Am Soc Surg Hand 4(3):200–213CrossRef
30.
Xiang Q, Yang J, Liu G, Tan W, Li H, Zhang S (2012) Anatomical study on contralateral C7 nerve transfer via posterior spinal route for treatment of brachial plexus root avulsion injury. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 26(2):235–237PubMed
31.
Xu JG, Wang H, Hu SN, Go YD (2004) Selective transfer of the C7 nerve root: an experimental study. J Reconstr Microsurg 20(6):463–470CrossRefPubMed
32.
Xu L, Go Y, Xu J, Lin S, Chen L, Lu J (2008) Contralateral C7 transfer via the prespinal and retropharyngeal route to repair brachial plexus avulsion: a preliminary report. Neurosurgery 63(3):553–559CrossRefPubMed
33.
Yang JY, Chen L, Gu Y, Chen D, Wang T (2011) Selective neurotization of the radial nerve in the axilla using a full-length phrenic nerve to treat complete brachial plexus palsy: an anatomy study and case report. Neurosurgery 68(6):1648–1653CrossRefPubMed
34.
Yu ZJ, Sui S, Yu S, Huang Y, Sheng J (2003) Contralateral C7 nerve transfer standard after upper arm shortening for the treatment of complete root avulsion of the brachial plexus: a preliminary report. Plast Reconstr Surg 111(4):465–469CrossRef
Metadaten
Titel
Transdiscal C6–C7 contralateral C7 nerve root transfer in the surgical repair of brachial plexus avulsion injuries
verfasst von
Vicente Vanaclocha
Juan Manuel Herrera
Francisco Verdu-Lopez
Laurabel Gozalbes
Moises Sanchez-Pardo
Marlon Rivera
Deborah Martinez-Gomez
Juan D. Mayorga
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
Acta Neurochirurgica / Ausgabe 12/2015
Print ISSN: 0001-6268
Elektronische ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-015-2596-0

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