Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.
Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Shanghai, China.
Br J Neurosurg. 2024 Apr;38(2):510-513. doi: 10.1080/02688697.2021.1910764. Epub 2021 Apr 10.
Contralateral C7 to C7 cross nerve transfer has been proved to be safe and effective for patients with spastic arm paralysis due to stroke and traumatic brain injury. For the lower limb, contralateral L5 to S1 cross nerve transfer serves as a novel surgical approach. In many cases, patients with hemiplegia have both upper and lower limb dysfunction and hope to restore all limb functions within one operation. To cope with this demand, we performed combined contralateral C7 to C7 and L5 to S1 cross nerve transfer in two cases successfully.
Two patients were enrolled in this study. The first patient is a 36-year-old woman who had spasticity and hemiplegia in both upper and lower limbs on the left side after a right cerebral hemorrhage 14 years prior. The second patient is a 64-year-old man who suffered from permanent muscle weakness in his right limbs, especially the leg, after a left cerebral hemorrhage 7 years prior. Both patients underwent the combined nerve transfer to improve upper and lower limb motor functions simultaneously. During the 10-month follow-up after surgery, the limb functions of both patients improved significantly.
This study demonstrates the safety and benefits of combined contralateral C7 to C7 and L5 to S1 cross nerve transfer for hemiplegic patients after stroke. This novel combined surgical approach could provide an optimal choice for patients suffering from both upper and lower limb dysfunction, to reduce hospital stay while reducing financial burden.
对于因中风和颅脑损伤导致的痉挛性臂瘫患者，对侧 C7 到 C7 交叉神经移植已被证实是安全有效的。对于下肢，对侧 L5 到 S1 交叉神经移植是一种新的手术方法。在许多情况下，偏瘫患者上肢和下肢都有功能障碍，希望在一次手术中恢复所有肢体功能。为了满足这一需求，我们成功地对两例患者进行了联合对侧 C7 到 C7 和 L5 到 S1 交叉神经移植。
本研究纳入了两例患者。第一例患者是一名 36 岁女性，14 年前因右侧脑出血导致左侧上下肢痉挛性偏瘫。第二例患者是一名 64 岁男性，7 年前因左侧脑出血导致右侧肢体永久性肌无力，尤其是腿部。两名患者均接受了联合神经移植，以同时改善上肢和下肢的运动功能。手术后 10 个月的随访期间，两名患者的肢体功能均显著改善。
本研究表明，联合对侧 C7 到 C7 和 L5 到 S1 交叉神经移植对于中风后偏瘫患者是安全且有益的。这种新的联合手术方法为同时患有上下肢功能障碍的患者提供了一个较好的选择，可以减少住院时间和经济负担。
