Contralateral C7 Transfer to Axillary and Median Nerves in Rats with Total Brachial Plexus Avulsion

Abstract

Background: Contralateral cervical 7 nerve (cC7) was used to repair two recipient nerves simultaneously for patients with total brachial plexus avulsion (TBPA). Objective: To evaluate the effect of cC7 transfer to axillary and median nerves in rats with TBPA. Methods: Eighty S-D rats were divided into 4 groups randomly on average. Group A: cC7 － median nerve, Group B: cC7 － axillary nerve, Group C: cC7 － median and axillary nerves, Group D: TBPA without repair. The evaluation tools included behavioral tests, electromyogram (EMG), measurement of cross-sectional area of muscle fiber, nerve fiber count and gene expression assay. Results: The effective rates of EMG were 90% and 70% in Flexor Carpi Radialis (FCR) in Group A and C, while 70% and 60% in deltoid (DEL) in Group B and C, respectively. In behavioral test, the differences of effective rates between groups were not significant. The mean cross-sectional area of FCR in Group A or C was significantly larger than that in Group D. Either the number of median or axillary nerve fibers in Group A, B or C was statistically more than that in Group D. No matter for FCR or DEL, there were no significant differences in the ratios of relative expression of Muscle Atrophy F-box （ MAFBOX ） and Muscle RING Finger 1 （ MURF1 ） among these groups. Conclusion: Compared with cC7 transfer to median nerve, cC7 transfer to both median and axillary nerves did not affect median nerve recovery. The deltoid muscle also could be restored. The recovery proportion of axillary nerve was less than that of median nerve.