Neurosurg Focus. 2018 Jan;44(VideoSuppl1):V4. doi: 10.3171/2018.1.FocusVid.17569.
Particularly challenging after complete brachial plexus avulsion is reestablishing effective hand function, due to limited neurological donors to reanimate the arm. Acute repair of avulsion injuries may enable reinnervation strategies for achieving hand function. This patient presented with pan-brachial plexus injury. Given its irreparable nature, the authors recommended multistage reconstruction, including contralateral C-7 transfer for hand function, multiple intercostal nerves for shoulder/triceps function, shoulder fusion, and spinal accessory nerve-to-musculocutaneous nerve transfer for elbow flexion. The video demonstrates distal contraction from electrical stimulation of the avulsed roots. Single neurorrhaphy of the contralateral C-7 transfer was performed along with a retrosternocleidomastoid approach. The video can be found here: https://youtu.be/GMPfno8sK0U .
臂丛完全撕脱后，由于手臂可供神经再支配的神经源有限，因此很难恢复有效的手部功能。急性修复撕脱伤可能为实现手部功能提供神经再支配策略。该患者表现为全臂丛神经损伤。鉴于其不可修复的性质，作者建议进行多阶段重建，包括对侧 C7 转移以恢复手部功能，多个肋间神经转移以恢复肩部/三头肌功能，肩部融合，以及副神经至肌皮神经转移以恢复肘部弯曲功能。该视频展示了电刺激撕脱神经根后的远端收缩。对侧 C7 转移的单神经吻合术与经胸骨舌骨肌入路同时进行。该视频可在此处找到：https://youtu.be/GMPfno8sK0U 。
