Xiang Qiansheng, Yang Juntao, Liu Guanlan, Tan Wenfu, Li Hao, Zhang Sisi
Department of Orthopedics, the Second Affiliated Hospital of Nanhua University, Hengyang Hunan, 421001, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Feb;26(2):235-7.
To investigate the feasibility of contralateral C7 nerve transfer via posterior spinal route for treatment of brachial plexus root avulsion injury by anatomical study.
Ten cadaveric specimens of 7 men and 3 women were selected, who had no obvious deformity and no tissue defect in neck neutral position. By simulating surgical exploration of brachial plexus injury, the length of contralateral C7 nerve root was elongated by dissecting its anterior and posterior divisions to the distal end, while the length of C7 nerve from the intervertebral foramen to the branching point and the length of the anterior and posterior divisions were measured. By simulating cervical posterior approach, the C7 vertebral plate and T1 spinous process were fully exposed; the hole was made near vertebral body; and the C7 nerve root lengths by posterior vertebra path to the contralateral upper trunk and lower trunk were measured.
C7 nerve root length was (58.62 +/- 8.70) mm; the length of C7 nerve root plus posterior or anterior division was (65.15 +/- 9.11) mm and (70.03 +/- 10.79) mm, respectively. By posterior spinal route, the distance was (72.12 +/- 10.22) mm from the end of C7 nerve to the contralateral upper trunk of brachial plexus, and was (95.21 +/- 12.50) mm to the contralateral lower trunk of brachial plexus.
Contralateral C7 nerve can be transferred to the contralateral side through posterior spinal route and it only needs short bridge nerve or no. The posterior spinal route can effectively prevent from neurovascular injury, so it might be the best surgery approach for the treatment of brachial plexus root avulsion injury.
通过解剖学研究探讨经后路行健侧C7神经移位治疗臂丛神经根性撕脱伤的可行性。
选取10例尸体标本，男7例，女3例，颈部中立位时无明显畸形及组织缺损。模拟臂丛神经损伤手术探查，将健侧C7神经根的前后支向远端解剖游离以延长其长度，同时测量C7神经根从椎间孔至分支点的长度及前后支的长度。模拟颈后路手术入路，充分显露C7椎板及T1棘突；在椎体旁开孔；测量经后路C7神经根至对侧臂丛上干及下干的长度。
C7神经根长度为(58.62±8.70)mm；C7神经根加后支或前支的长度分别为(65.15±9.11)mm和(70.03±10.79)mm。经后路，C7神经末端至对侧臂丛上干的距离为(72.12±10.22)mm，至对侧臂丛下干的距离为(95.21±12.50)mm。
健侧C7神经可经后路移位至对侧，仅需短桥接神经或无需桥接神经。后路手术可有效避免神经血管损伤，可能是治疗臂丛神经根性撕脱伤的最佳手术入路。
