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一期双运动神经移位治疗医源性C8-T1脊神经损伤所致全指屈曲功能障碍:1例报告并文献复习

Single-stage double motor nerve transfer for all finger flexion in iatrogenic C8-T1 spinal nerve injury: a case report and review of literature.

作者信息

Jitpun Ekkapot, Rojanawatsirivej Apimid, Tangviriyapaiboon Teera

机构信息

Department of Neurosurgery, Neurological Institute of Thailand, 312, Rajavithi Road, Thung Phayathai, Ratchathewi, Bangkok, Thailand.

Department of Pediatric Neurology, Neurological Institute of Thailand, Bangkok, Thailand.

出版信息

Acta Neurochir (Wien). 2022 Oct;164(10):2683-2688. doi: 10.1007/s00701-022-05264-0. Epub 2022 Jun 4.

Abstract

Restoration of hand function after C8-T1 spinal nerve injury is challenging. We report a case of a young patient who underwent single-stage transfer of extensor carpi radialis brevis (ECRB) branch of radial nerve to flexor digitorum superficialis (FDS) branch of median nerve and transfer of brachialis branch of musculocutaneous nerve to anterior interosseous nerve (AIN), aiming for restoration of all finger flexion in iatrogenic C8-T1 spinal nerve injury after the resection of a dumbbell-shaped C8 neurofibroma. At 18 months after the operation, the fingers and thumb functions were successfully restored. The operation might be useful for restoration of hand function in selected patients with C8, T1 brachial plexus injury. From the literature review, this is the first case that the technique of double motor nerve transfer and the transfer of ECRB branch to FDS branch were used to restore finger flexion in a patient with brachial plexus injury.

摘要

C8 - T1 脊神经损伤后手功能的恢复具有挑战性。我们报告了一例年轻患者的病例,该患者接受了桡神经桡侧腕短伸肌(ECRB)分支至正中神经指浅屈肌(FDS)分支的单阶段转移,以及肌皮神经肱肌分支至骨间前神经(AIN)的转移,旨在恢复哑铃形 C8 神经纤维瘤切除术后医源性 C8 - T1 脊神经损伤患者的所有手指屈曲功能。术后 18 个月,手指和拇指功能成功恢复。该手术可能对选定的 C8、T1 臂丛神经损伤患者的手功能恢复有用。从文献回顾来看,这是首例采用双运动神经转移技术以及将 ECRB 分支转移至 FDS 分支来恢复臂丛神经损伤患者手指屈曲功能的病例。

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