Brunelli G A
Fondazione Midollo Spinale, Brescia, Italy.
J Hand Surg Eur Vol. 2007 Dec;32(6):620-5. doi: 10.1016/J.JHSE.2007.10.002.
This paper reports experimental work in rats in which the radial nerve was cut at its origin from the brachial plexus and connected by means of a nerve graft to the corticospinal tract of the spinal cord at the T3-T4 level. After surgery, the triceps and extensor muscles of the forearm were able to extend the elbow and the wrist and gave almost normal responses on EMG. This reinnervation was no longer cholinergic, as demonstrated by the Vecuronium test. Because of the drawbacks associated with implantation into the spinal cord, this technique could not be used in all cases of total avulsion of the brachial plexus but it might be useful in those rare cases in which avulsion of all the cervical nerves of the brachial plexus is associated with paraplegia: such cases are rare but are occasionally seen.
本文报道了在大鼠身上进行的实验工作,其中桡神经在其从臂丛神经发出的起始处被切断,并通过神经移植与脊髓T3 - T4水平的皮质脊髓束相连。手术后,肱三头肌和前臂伸肌能够伸展肘部和腕部,并且在肌电图上给出几乎正常的反应。如维库溴铵试验所示,这种重新支配不再是胆碱能的。由于与植入脊髓相关的缺点,这种技术不能用于所有臂丛神经完全撕脱的病例,但在那些罕见的臂丛神经所有颈神经撕脱伴有截瘫的病例中可能有用:这种病例很少见,但偶尔会出现。