Luo WenMiao, Yan ZhengCun, Guo Yu, Xu Ji, Zhang Heng-Zhu
Northern Jiangsu People's Hospital, Yangzhou, China.
Department of Neurosurgery, The Yangzhou School of Clinical Medicine of Dalian Medical University, Yangzhou, China.
Front Neurol. 2023 Aug 17;14:1113254. doi: 10.3389/fneur.2023.1113254. eCollection 2023.
The specific benefits of a contralateral cervical 7 nerve transplant in people with spastic paralysis of the upper extremity caused by cerebral nerve injury are unclear. To evaluate the efficacy and safety of contralateral C7 nerve transfer for central spastic paralysis of the upper extremity, we conducted a comprehensive literature search and meta-analysis.
PRISMA guidelines were used to search the databases for papers comparing the efficacy of contralateral cervical 7 nerve transfer vs. rehabilitation treatment from January 2010 to August 2022. The finishing indications were expressed using SMD ± mean. A meta-analysis was used to assess the recovery of motor function in the paralyzed upper extremity.
The meta-analysis included three publications. One of the publications offers information about RCTs and non-RCTs. A total of 384 paralyzed patients were included, including 192 who underwent CC7 transfer and 192 who received rehabilitation. Results from all patients were combined and revealed that patients who had CC7 transfer may have regained greater motor function in the Fugl-Meyer score (SMD 3.52, 95% CI = 3.19-3.84, < 0.00001) and had superior improvement in range of motion compared to the rehabilitation group (SMD 2.88, 95% CI = 2.47-3.29, < 0.00001). In addition, the spasticity in the paralyzed upper extremity significantly improved in patients with CC7 transfer (SMD -1.42, 95% CI = -1.60 to -1.25, < 0.00001).
Our findings suggested that a contralateral C7 nerve transfer, which has no additional adverse effects on the healthy upper limb, is a preferable method to restore motor function.
对于因脑神经损伤导致上肢痉挛性瘫痪的患者，进行对侧颈7神经移植的具体益处尚不清楚。为评估对侧C7神经移位术治疗上肢中枢性痉挛性瘫痪的有效性和安全性，我们进行了全面的文献检索和荟萃分析。
采用PRISMA指南检索数据库，查找2010年1月至2022年8月间比较对侧颈7神经移位术与康复治疗疗效的论文。结局指标用标准化均数差（SMD）±均值表示。采用荟萃分析评估瘫痪上肢运动功能的恢复情况。
荟萃分析纳入3篇文献。其中1篇文献提供了随机对照试验和非随机对照试验的信息。共纳入384例瘫痪患者，其中192例行对侧颈7神经移位术，192例接受康复治疗。汇总所有患者的结果显示，接受对侧颈7神经移位术的患者在Fugl-Meyer评分中运动功能恢复可能更好（SMD 3.52，95%CI = 3.19 - 3.84，P < 0.00001），与康复组相比，其关节活动度改善更优（SMD 2.88，95%CI = 2.47 - 3.29，P < 0.00001）。此外，接受对侧颈7神经移位术的患者瘫痪上肢的痉挛情况明显改善（SMD -1.42，95%CI = -1.60至-1.25，P < 0.00001）。
我们的研究结果表明，对侧C7神经移位术对健侧上肢无额外不良影响，是恢复运动功能的一种较好方法。
