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19例创伤后患者的臂丛神经显露:形态学解剖分析

Brachial plexus exposure in 19 post-traumatic patients: A morphometric anatomic analysis.

作者信息

Mandelli Carlo, Mura Cinzia, Albano Luigi, Mortini Pietro

机构信息

Department of Neurosurgery, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele, Milan, Italy.

Department of Neurosurgery, Ospedale San Raffaele, Milan, Italy.

出版信息

Surg Neurol Int. 2025 May 30;16:203. doi: 10.25259/SNI_173_2025. eCollection 2025.

Abstract

BACKGROUND

Traumatic brachial plexus injuries result in severe functional impairment, significantly affecting patients' quality of life. This study aims to evaluate the clinical outcomes of surgical interventions in 19 patients with brachial plexus injuries, emphasizing the effectiveness of linear incision techniques. Our surgical objectives included restoring shoulder control, elbow flexion, and elbow extension, alongside optimizing sensory recovery.

METHODS

We performed morphometric analyses to standardize surgical approaches, utilizing topographic linear incisions for enhanced exposure and precision. This technique ensures critical advantages: short incisions with excellent nerve visualization, identification of consistent anatomical landmarks for safe dissection even amidst scar tissue, and facilitation of multiple neurotizations through single incisions. This approach is inspired by and builds on the principles outlined by Bertelli and Ghizoni, whose work highlighted the importance of precise anatomical dissection and efficient nerve exposure.

RESULTS

We collected all morphometric measurements to standardize surgical approaches. Key findings demonstrated that linear incisions improved surgical efficiency and facilitated tension-free nerve anastomoses without the need for grafts in most cases.

CONCLUSION

Linear incision techniques, supported by the foundational principles established by Bertelli and Ghizoni, provide significant clinical benefits in brachial plexus surgery. This approach enhances both surgical precision and patient recovery while supporting the achievement of critical neurofunctional objectives.

摘要

背景

创伤性臂丛神经损伤会导致严重的功能障碍,显著影响患者的生活质量。本研究旨在评估19例臂丛神经损伤患者手术干预的临床结果,重点关注线性切口技术的有效性。我们的手术目标包括恢复肩部控制、肘关节屈曲和伸展,同时优化感觉恢复。

方法

我们进行了形态学分析以规范手术方法,采用地形线性切口以增强暴露和精度。该技术具有关键优势:切口短,神经可视化效果极佳;即使在瘢痕组织中也能识别一致的解剖标志以进行安全解剖;通过单一切口便于进行多次神经移植。这种方法受到Bertelli和Ghizoni概述的原则的启发并在此基础上发展而来,他们的工作强调了精确解剖和有效神经暴露的重要性。

结果

我们收集了所有形态学测量数据以规范手术方法。主要发现表明,线性切口提高了手术效率,并且在大多数情况下无需移植即可促进无张力神经吻合。

结论

在Bertelli和Ghizoni确立的基本原则支持下,线性切口技术在臂丛神经手术中具有显著的临床益处。这种方法提高了手术精度和患者恢复效果,同时有助于实现关键的神经功能目标。

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