Muhetidier Abula, Yilixiati Saiwulaiti, Gulinaer Yiming, Aihemaitijiang Yusufu
Department of Microsurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi Xinjiang 830054, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Nov;25(11):1364-6.
To observe the recovery of the sensory and motor function of the repaired limb and the impact on the healthy limb function after contralateral C7 nerve root transposition for treating brachial plexus root avulsion injury.
Between August 2008 and November 2010, 22 patients with brachial plexus root avulsion injuries were treated with contralateral C7 nerve root transposition. All patients were male, aged 14 to 47 years (mean, 33.3 years). Total brachial plexus root avulsion was confirmed by preoperative clinical examination and electrophysiological tests. In 22 cases, median nerve was repaired in 16 cases, radial nerve in 3 cases, and musculocutaneous nerve in 3 cases; primary operation was performed in 2 patients, and two-stage operation was performed in 20 patients. The sensory and motor functional recovery of the repaired limb was observed after operation.
Twenty-one patients were followed up 7-25 months (mean, 18.4 months). In 16 cases of contralateral C7 nerve root transposition to the median nerve, wrist flexors reached more than M3 in 10 cases, while finger flexors reached more than M3 in 7 cases; sensation reached more than S3 in 11 cases. In 3 cases of contralateral C7 nerve root transposition to the musculocutaneous nerve, elbow flexors reached more than M3 in 2 cases; sensation reached more than S3 in 2 cases. In 3 cases of contralateral C7 nerve root transposition to the radial nerve, wrist extensor reached more than M3 in 1 case; sensation reached more than S3 in 1 case.
Contralateral C7 nerve root transposition is a good procedure for the treatment of brachial plexus root avulsion injury. Staged operation is one of important factors influencing treatment outcome.
观察对侧C7神经根转位治疗臂丛神经根性撕脱伤后修复肢体感觉和运动功能的恢复情况以及对健侧肢体功能的影响。
2008年8月至2010年11月，对22例臂丛神经根性撕脱伤患者行对侧C7神经根转位治疗。所有患者均为男性，年龄14～47岁（平均33.3岁）。术前经临床检查及电生理测试确诊为全臂丛神经根性撕脱伤。22例中，正中神经修复16例，桡神经修复3例，肌皮神经修复3例；2例行一期手术，20例行二期手术。术后观察修复肢体的感觉和运动功能恢复情况。
21例患者获7～25个月（平均18.4个月）随访。16例对侧C7神经根转位至正中神经者，腕屈肌肌力达M3以上者10例，指屈肌肌力达M3以上者7例；感觉恢复达S3以上者11例。3例对侧C7神经根转位至肌皮神经者，肘屈肌肌力达M3以上者2例；感觉恢复达S3以上者2例。3例对侧C7神经根转位至桡神经者，腕伸肌肌力达M3以上者1例；感觉恢复达S3以上者1例。
对侧C7神经根转位是治疗臂丛神经根性撕脱伤的一种良好术式。分期手术是影响治疗效果的重要因素之一。
