Emamhadi Mohammadreza, Chabok Shahrokh Yousefzadeh, Samini Fariborz, Alijani Babak, Behzadnia Hamid, Firozabadi Fariborz Ayati, Reihanian Zoheir
Department of Neurosurgery, Brachial Plexus and Peripheral Nerve Injury Center, Guilan University of Medical Science, Rasht, Iran.
Arch Bone Jt Surg. 2016 Jun;4(3):253-8.
Variations of the brachial plexus are common and a better awareness of the variations is of crucial importance to achieve successful results in its surgical procedures. The aim of the present study was to evaluate the anatomical variations of the brachial plexus in adult cadavers.
Bilateral upper limbs of 32 fresh cadavers (21 males and 11 females) consecutively referred to Guilan legal medicine organization from November 2011 to September 2014, were dissected and the trunks, cords and terminal nerves were evaluated.
Six plexuses were prefixed in origin. The long thoracic nerve pierced the middle scalene muscle in 6 cases in the supra clavicular zone. The suprascapular nerve in 7 plexuses was formed from posterior division of the superior trunk. Five cadavers showed anastomosis between medial brachial cutaneous nerve and T1 root in the infra clavicular zone. Terminal branches variations were the highest wherein the ulnar nerve received a communicating branch from the lateral cord in 3 cases. The median nerve was formed by 2 lateral roots from lateral cord and 1 medial root from the medial cord in 6 cadavers. Some fibers from C7 root came to the musculocutaneous nerve in 8 cadavers.
The correlation analysis between the variations and the demographic features was impossible due to the small sample size. The findings of the present study suggest a meta-analysis to assess the whole reported variations to obtain a proper approach for neurosurgeons.
臂丛神经变异很常见，更好地了解这些变异对于在其外科手术中取得成功结果至关重要。本研究的目的是评估成年尸体中臂丛神经的解剖变异。
对2011年11月至2014年9月连续转诊至吉兰法医机构的32具新鲜尸体（21例男性和11例女性）的双侧上肢进行解剖，并对干、束和终末神经进行评估。
6例臂丛神经起源为前置型。在锁骨上区，6例中胸长神经穿过中斜角肌。7例臂丛神经中，肩胛上神经由上干后股形成。5具尸体在锁骨下区显示臂内侧皮神经与T1神经根之间有吻合。终末分支变异最多，其中3例尺神经接受来自外侧束的交通支。6具尸体中，正中神经由外侧束的2个外侧根和内侧束的1个内侧根形成。8具尸体中，C7神经根的一些纤维进入肌皮神经。
由于样本量小，无法对变异与人口统计学特征进行相关性分析。本研究结果提示进行荟萃分析，以评估所有已报道的变异，为神经外科医生获得合适的方法。
