Anatomic study of the intercostal nerve transfer to the suprascapular nerve and a case report

Hu, Song; Chu, Bin; Song, Jie; Chen, L.

doi:10.1177/1753193413475963

Cited by 6 publications

(4 citation statements)

References 13 publications

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“…Taking this into consideration, we chose intercostal nerves as donor nerves for restoration of shoulder abduction and elbow flexion. Previous studies 14,21 proved the anatomic feasibility of transferring the third-to-sixth intercostal nerves to the suprascapular nerve. All 4 intercostal nerves could be directly transferred and coapted to the anterior branch of the axillary nerve via a posterior approach, without tension on the coaptation site under both 45°and 90°of passive shoulder abduction.…”

mentioning

confidence: 98%

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Chu¹,

Wang²,

Chen³

et al. 2016

Annals of Plastic Surgery

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The purpose of this study was to investigate the effectiveness of shoulder function restoration by dual nerve transfers, spinal accessory nerve to the suprascapular nerve and 2 intercostal nerves to the anterior branch of the axillary nerve, in patients with shoulder paralysis that resulted from brachial plexus avulsion injury. It was a retrospective analysis to assess the impact of a variety of factors on reanimation of shoulder functions with dual nerve transfers. A total of 19 patients were included in this study. Most of these patients sustained avulsions of C5, C6, and C7 nerve roots (16 patients). Three of them had avulsions of C5 and C6 roots only. Through a posterior approach, direct coaptation of the intercostal nerves and the anterior branch of the axillary nerve was performed, along with accessory nerve transfer to the suprascapular nerve. Satisfactory shoulder function recovery (93.83° of shoulder abduction and 54.00° of external rotation on average) was achieved after a 62-month follow-up. This dual nerve transfer procedure provided us with a reliable and effective method for shoulder function reconstruction after brachial plexus root avulsion, especially C5/C6/C7 avulsion. The level of evidence is therapeutic IV.

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confidence: 98%

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Chu¹,

Wang²,

Chen³

et al. 2016

Annals of Plastic Surgery

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“…The SAN is the most acceptable and commonly used donor nerve for transfer to the SSN either from an anterior or a posterior approach ( 8 – 11 ); however, it can be concomitantly injured in up to 6–16% of upper plexus injuries ( 12 ). Other potential donor nerves include the intercostal nerves ( 13 ), phrenic nerve ( 14 ), and contralateral SAN ( 15 ). Both the SAN and phrenic nerves were unavailable for use in this case.…”

Section: Discussionmentioning

confidence: 99%

Vascularized Thoracodorsal to Suprascapular Nerve Transfer, a Novel Technique to Restore Shoulder Function in Partial Brachial Plexopathy

Potter

Ferris

2016

Front. Surg.

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We describe the clinical outcome of a novel nerve transfer to restore active shoulder motion in upper brachial plexus injury. The thoracodorsal nerve (TDN) was successfully used as a vascularized donor nerve to neurotize to the suprascapular nerve (SSN) in a patient with limited donor nerve availability. At 4 years follow-up, he had regained useful external rotation of the injured limb, with no significant donor site morbidity. Shoulder abduction return was less impressive, however, and reasons for this are discussed. We provide a comprehensive review of the literature on this topic and a subsequent discussion on the details of this novel technique. This is the first reported case of TDN to SSN transfer, and also the first reported case of a vascularized TDN transfer in the English language literature. We advocate direct thoracodorsal to SSN transfer as a valid surgical option for the restoration of shoulder function in patients with partial brachial plexus avulsion, when conventional nerve donors are unavailable.

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“…Other donor nerves that have been used to re-innervate the SSN and AXN are the C 3 and C 4 anterior rami [88], ICNs [89][90][91][92], TDN [60], MPN [93,94], LTN [95], PHN [96], subscapular nerve [97], rhomboid nerve [98], ipsilateral or contralateral C 7 nerve root [99] and hypoglossal nerve [100]. They can be used but only if the SAN to SSN and TLH to AXN transfers are not possible, as their clinical outcome is unsatisfactory [17,22].…”

Section: Shoulder Nerve Transfersmentioning

confidence: 99%

“…At least two of them per recipient nerve are needed [24,124]. They have been used to re-innervate many nerves, like the AXN [89,92], MCN [24,105,106,[124][125][126], TLH [92,118,119], TDN [89,127] and SSN [90,91]. Their sensory branches can be used to recover some limb sensation, ameliorating the neuropathic pain.…”

Section: Intercostal Nerve Transfersmentioning

confidence: 99%

Nerve Transfers in the Treatment of Peripheral Nerve Injuries

Vanaclocha‐Vanaclocha¹,

Ortiz-Criado²,

NievesSáiz-Sapena³

et al. 2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Successful re-innervation of proximal limb peripheral nerve injuries is rare. Axons regenerate at ~1 mm/day, reaching hand muscles by 24 months, finding them atrophied and fibrosed. Peripheral nerve injury repair is often delayed waiting for spontaneous recovery. This waiting time should not be longer than 6 months as after 18 months reinnervation will not achieve effective muscular function. When spontaneous recovery is impossible, referral too late or damage too severe, other options like a transfer from a nearby healthy nerve to the injured one must be considered. They are very successful, and the deficit in the donor site is usually minimal. The most common nerve transfers are a branch of the spinal nerve to the trapezius muscle to the suprascapular nerve, a branch of the long head of the triceps to the axillary nerve, a fascicle of the ulnar nerve to the motor branch of the biceps muscle, two branches of the median nerve to the posterior interosseous nerve and the anterior interosseous nerve to the ulnar nerve. There are many more options that can suit particular cases. Introduced in brachial plexus injury repair, they are now also applied to lower limb, to stroke and to some spinal cord injuries.

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Anatomic study of the intercostal nerve transfer to the suprascapular nerve and a case report

Cited by 6 publications

References 13 publications

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Dual Nerve Transfers for Restoration of Shoulder Function After Brachial Plexus Avulsion Injury

Vascularized Thoracodorsal to Suprascapular Nerve Transfer, a Novel Technique to Restore Shoulder Function in Partial Brachial Plexopathy

Nerve Transfers in the Treatment of Peripheral Nerve Injuries

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