Partial Ipsilateral C7
Transfer to the Upper Trunk for C5-C6 Avulsion of the Brachial Plexus
Authors: Yin H, Su J, Xu WD, Xu L, Xu JG, Gu YD
Source: Neurosurgery. 2011 Nov 8
Yin et al. from
Shanghai developed ipsilateral partial C7 root transfer in treating C5-C6 avulsion.
The authors state
"Ipsilateral whole C7 root transfer has been reported in treating C5-C6
avulsion. To minimize donor deficits, partial ipsilateral C7 (PIC7)
transfer was developed".
authors prospectively studied eight young adults with C5-C6 avulsion.
Five patients (Group A) who also had spinal accessory nerve (SAN)
injury underwent PIC7 transfer to the upper trunk. The other three
patients (Group B) without SAN injury underwent a combination of PIC7
to the upper trunk and the SAN to the suprascapular nerve (SSN).
Postsurgical evaluations including donor deficits, functional recovery
and co-contraction of the muscles were performed one week later and
then at intervals of 3 months.
The authors found
a mean period of 39.2 months, all subjects were found to have gained
elbow flexion of 110-150° with muscle strength of M4-5. The patients in
Group B achieved external rotation of 60-70° at M3-4, and two achieved
shoulder abductions approaching 180° at M4. The patients in Group A
showed no active external rotation and shoulder abduction of 25-50° at
M2-3. The temporary deficits caused by PIC7 transfer disappeared in all
subjects within the first 3 months. Co-contraction of the latissimus
dorsi against the deltoid was recorded in Group A but not in Group B".
Conclusion of the
authors: "ipsilateral partial C7 root
transfer, when combined with SAN transfer to SSN as a novel approach,
is a safe, easy and efficacious surgical procedure for patients with
simple C5-C6 avulsion".
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