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首页> 外文期刊>Neurosurgery >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.
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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.

机译：对侧C7通过皮下隧道穿过胸部和颈部的前表面转移至下躯干，导致臂丛神经全根撕脱：初步报告。

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摘要

OBJECTIVE: We investigate an innovative and efficacious procedure for restoring wrist flexion, finger flexion, and hand sensation by passing the contralateral C7 through a subcutaneous tunnel across the anterior surface of the chest and neck. METHODS: Four patients (3 men, 1 woman) with total brachial plexus avulsion were treated from November 2005 to July 2007, their ages ranging from 18 to 36 years (average, 26 years). The operative delay was from 23 days to 5 months (mean, 2 months). The contralateral C7 nerve root was employed to repair the injured lower trunk or the C8-T1 spinal nerves via the subcutaneous tunnel across the anterior surface of the chest and neck. Direct neurorrhaphy was performed on the C8-T1 residual nerve roots in 2 patients. In the other 2 patients, a nerve graft of 4.5 cm in length was used to restore function of the affected lower trunk. RESULTS: Postoperative electromyography at 26 and 38 months recorded compound muscle action potentials and motor unit potentials in the abductor digiti minimi and the flexor pollicis longus in all cases. On clinical examination digital flexion scored M1-M3, carpal flexion M2-M4, and hand sensation S1-S3. CONCLUSION: Transfer of the contralateral C7 to the lower trunk proved to be a safe and feasible procedure. Compared with the traditional transfer of the contralateral C7 to the median nerve, it might help patients gain better restoration of wrist flexion, finger flexion, and hand sensation.
机译：目的：我们研究了一种创新且有效的方法，通过使对侧C7穿过皮下隧道穿过胸部和颈部的前表面，来恢复腕部屈曲，手指屈曲和手感。方法：2005年11月至2007年7月，对4例全臂丛神经撕脱伤患者进行了治疗（3例男性，1例女性），年龄18至36岁（平均26岁）。手术延迟为23天至5个月（平均2个月）。对侧C7神经根经皮下隧道穿过胸部和颈部的前表面修复受损的下躯干或C8-T1脊神经。对2例患者的C8-T1残留神经根进行了直接神经性腹泻。在另外2名患者中，使用4.5cm长的神经移植物恢复受影响的下躯干的功能。结果：术后26个月和38个月的肌电图记录了在所有情况下的数指外展肌和长屈肌弯曲的复合肌肉动作电位和运动单位电位。在临床检查中，数字屈曲评分为M1-M3，腕屈曲评分为M2-M4，手感评分为S1-S3。结论：将对侧C7转移到下躯干是一种安全可行的方法。与传统的将对侧C7转移到正中神经相比，它可以帮助患者更好地恢复腕部屈曲，手指屈曲和手感。

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