Department of Neurosurgery, Spine Center, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA.
Neurosurgery. 2009 Oct;65(4 Suppl):A55-62. doi: 10.1227/01.NEU.0000341165.83218.AC.
To review the clinical outcomes in our patients who have undergone nerve transfer operations for brachial plexus reconstruction at the Louisiana State University (LSU) over a 10-year period. A secondary objective is to compare clinical outcomes in patients who had only nerve transfer operations as compared with patients whose nerve transfers were supplemented with direct repair of brachial plexus elements.
Retrospective review of the medical records, imaging, and electrodiagnostic studies (electromyographic and nerve conduction studies) of patients with brachial plexus injuries who underwent nerve transfer operations at LSU over a period of 10 years.
A total of 81 patients were treated between 1995 to 2005 at the LSU Health Sciences Center; 7 of these patients were lost to follow-up, leaving 74 patients, with an average follow-up of 3.5 years, for review. We evaluated recovery of elbow flexion and shoulder abduction. Ninety percent of patients with medial pectoral to musculocutaneous nerve transfers recovered to LSU grade 2 (Medical Research Council grade 3), and 60% of those patients with intercostal to musculocutaneous nerve transfer regained similar strength in elbow flexion. Shoulder abduction recovery to LSU grade 2 (Medical Research Council grade 3) after spinal accessory to suprascapular and/or thoracodorsal to axillary nerve transfer, was 95% and 36%, respectively. There was a tendency for better motor recovery when nerve transfer operations were combined with direct repair of plexus elements.
Nerve transfers for repair of brachial plexus injuries result in excellent recovery of elbow and shoulder functions. Patients who had direct repair of brachial plexus elements in addition to nerve transfers tended to do better than those who had only nerve transfer operations.
回顾在路易斯安那州立大学（LSU）进行神经转移手术治疗臂丛重建的患者 10 年来的临床结果。次要目标是比较仅进行神经转移手术的患者与神经转移手术辅以臂丛神经直接修复的患者的临床结果。
回顾性分析在 LSU 进行神经转移手术的臂丛神经损伤患者的病历、影像学和电诊断研究（肌电图和神经传导研究）。
1995 年至 2005 年期间，LSU 健康科学中心共治疗了 81 名患者；其中 7 名患者失访，留下 74 名患者，平均随访 3.5 年进行回顾。我们评估了肘屈肌和肩外展的恢复情况。内侧胸大肌至肌皮神经转移的 90%患者恢复到 LSU 等级 2（肌电图研究委员会等级 3），肋间神经至肌皮神经转移的 60%患者恢复了类似的肘屈肌力量。副神经至肩胛上神经和/或胸背神经至腋神经转移后的肩外展恢复到 LSU 等级 2（肌电图研究委员会等级 3），分别为 95%和 36%。当神经转移手术与臂丛神经直接修复相结合时，运动功能恢复较好。
神经转移术治疗臂丛神经损伤可获得极好的肘和肩部功能恢复。与仅进行神经转移手术的患者相比，同时进行臂丛神经直接修复的患者恢复情况更好。
