Samardzic M, Grujicic D, Antunovic V
Neurosurgical Clinic, University Clinical Center, Belgrade, Yugoslavia.
J Neurosurg. 1992 Feb;76(2):191-7. doi: 10.3171/jns.1992.76.2.0191.
Brachial plexus palsy due to traction injury, especially spinal nerve-root avulsion, represents a severe handicap for the patient. Despite recent progress in diagnosis and microsurgical repair, the prognosis in such cases remains unfavorable. Nerve transfer is the only possibility for repair in cases of spinal nerve-root avulsion. This technique was analyzed in 37 patients with 64 reinnervation procedures of the musculocutaneous and/or axillary nerve using upper intercostal, spinal accessory, and regional nerves as donors. The most favorable results, with an 83.8% overall rate of useful functional recovery, were obtained in patients with upper brachial plexus palsy in which regional donor nerves, such as the medial pectoral, thoracodorsal, long thoracic, and subscapular nerves, had been used. The overall rates of recovery for the spinal accessory and upper intercostal nerves were 64.3% and 55.5%, respectively, which are significantly lower. The authors evaluate the results of nerve transfer and analyze different donor nerves as factors influencing the prognosis of surgical repair.
牵拉伤所致的臂丛神经麻痹，尤其是脊神经根撕脱伤，对患者来说是一种严重的残疾。尽管近年来在诊断和显微外科修复方面取得了进展，但此类病例的预后仍然不佳。对于脊神经根撕脱伤，神经移位是唯一的修复方法。本研究分析了37例患者，采用肋间上神经、副神经和局部神经作为供体，对肌皮神经和/或腋神经进行了64次神经再支配手术。在上臂丛神经麻痹患者中，使用局部供体神经（如胸内侧神经、胸背神经、胸长神经和肩胛下神经）取得了最理想的结果，总体有用功能恢复率为83.8%。副神经和肋间上神经的总体恢复率分别为64.3%和55.5%，明显较低。作者评估了神经移位的结果，并分析了不同供体神经作为影响手术修复预后的因素。
