The Hand and Microsurgery Center of El Paso, 10175 Gateway West Suite 230, El Paso, Texas, 79925, United States; Clinical Professor, Burrell Osteopathic College of Medicine, Las Cruces, New Mexico, United States.
Clin Neurol Neurosurg. 2020 Apr;191:105693. doi: 10.1016/j.clineuro.2020.105693. Epub 2020 Jan 23.
Peripheral neuropathic pain is a common and disabling problem after traumatic brachial plexus injury with global plexopathy secondary to C5 rupture and avulsion of C6, C7, C8, and T1. The purpose of this paper is to evaluate restoration of sensation and pain levels before and after targeted muscle reinnervation to the hand using contralateral C7 nerve transfers in patients who have traumatic brachial plexus injuries with C5 rupture and avulsion of C6, C7, C8, and T1.
This paper presents a retrospective review of the outcomes of the surgical management of 11 patients with global plexopathy with C5 rupture and avulsion from C6 to T1 roots. Ten of the patients had peripheral neuropathic pain. Mean follow-up was 6.9 years.
Sensory recovery to the median nerve territory was returned in 10 out of 11 patients. Pain and quality of life were improved in the majority.
Contralateral C7 nerve transfers may restore sensation to the median nerve territory with concurrent improvement in pain and some function in a limited number of patients for whom no other treatment options exist.
周围神经病理性疼痛是创伤性臂丛神经损伤后的常见且致残性问题，其全球多发性神经病是由于 C5 断裂和 C6、C7、C8 和 T1 的撕脱。本文旨在评估在创伤性臂丛神经损伤伴 C5 断裂和 C6 至 T1 神经根撕脱的患者中，通过对侧 C7 神经转移实现手部靶向肌肉再神经支配后，感觉和疼痛水平的恢复情况。
本文回顾性分析了 11 例 C5 断裂和 C6 至 T1 神经根撕脱的全臂丛神经病患者的手术治疗结果。其中 10 例患者存在周围神经病理性疼痛。平均随访时间为 6.9 年。
11 例患者中有 10 例恢复了正中神经支配区的感觉。大部分患者的疼痛和生活质量得到了改善。
对于没有其他治疗选择的患者，对侧 C7 神经转移可能会恢复正中神经支配区的感觉，并同时改善疼痛和部分功能。
