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- Title
Transdiscal C-C contralateral C nerve root transfer in the surgical repair of brachial plexus avulsion injuries.
- Authors
Vanaclocha, Vicente; Herrera, Juan; Verdu-Lopez, Francisco; Gozalbes, Laurabel; Sanchez-Pardo, Moises; Rivera, Marlon; Martinez-Gomez, Deborah; Mayorga, Juan
- Abstract
Background: Repair of complete brachial plexus avulsion injuries may require contralateral C 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 C-C contralateral C 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 C nerve root was sectioned just before it connects with other brachial plexus branches and re-routed though the C-C disc space to the contralateral side. A complete C-C discectomy was performed and the disc space kept open with the aid of an autologous iliac crest bone graft. Results: Transdiscal C-C contralateral C 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 C and T. Conclusions: Transdiscal C-C contralateral C nerve root transfer is technically feasible. In our dissections it lengthens the available C nerve root stump by 5.3 ± 1.2SDcm. The increase was 4 cm versus the retropharyngeal route making direct coaptation with the contralateral C and T nerve roots possible.
- Subjects
BRACHIAL plexus; WOUNDS &; injuries; AVULSION fractures; NEUROSURGERY; OPERATIVE surgery; BRAIN surgery
- Publication
Acta Neurochirurgica, 2015, Vol 157, Issue 12, p2161
- ISSN
0001-6268
- Publication type
Article
- DOI
10.1007/s00701-015-2596-0