Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; Department of Orthopedics, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Microsurgery. 2014 Feb;34(2):91-101. doi: 10.1002/micr.22148. Epub 2013 Aug 2.
We conducted a clinical study to evaluate the effects of neurotization, especially comparing the total contralateral C7 (CC7) root transfer to hemi-CC7 transfer, on total root avulsion brachial plexus injuries (BPI).
Forty patients who received neurotization for BPI were enrolled in this prospective study. Group 1 (n = 20) received hemi-CC7 transfer for hand function, while group 2 (n = 20) received total-CC7 transfer. Additional neurotization included spinal accessory, phrenic, and intercostal nerve transfer for shoulder and elbow function. The results were evaluated with an average of 6 years follow-up.
Group 1 had fewer donor site complications (15%) than group 2 (45%); group 2 had significantly better hand M3 and M4 motor function (65%) than group 1 (30%; P = 0.02). There was no difference in sensory recovery. Significantly, better shoulder function was obtained by simultaneous neurotization on both suprascapular and axillary nerves.
Total-CC7 transfer had better hand recovery but more donor complications than hemi-CC7. Neurotization on both supra-scapular and axillary nerves improved shoulder recovery.
我们进行了一项临床研究，评估神经化的效果，特别是比较全对侧 C7（CC7）根转移与半 CC7 转移对全根撕脱性臂丛神经损伤（BPI）的影响。
本前瞻性研究纳入了 40 名接受 BPI 神经化治疗的患者。第 1 组（n=20）接受半 CC7 转移以恢复手部功能，第 2 组（n=20）接受全 CC7 转移。附加的神经化包括副神经、膈神经和肋间神经转移以恢复肩部和肘部功能。平均随访 6 年后评估结果。
第 1 组供区并发症（15%）少于第 2 组（45%）；第 2 组手部 M3 和 M4 运动功能（65%）显著优于第 1 组（30%；P=0.02）。感觉恢复无差异。重要的是，肩胛上神经和腋神经的同时神经化可获得更好的肩部功能。
全 CC7 转移对手部恢复效果更好，但供区并发症更多。肩胛上神经和腋神经的神经化均可改善肩部恢复。
