Nerve transfer for sensory reconstruction of C8‐T1 dermatomes in tetraplegia

Bertelli, Jayme Augusto; Ghizoni, Marcos Flávio

doi:10.1002/micr.30088

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…Nerve transfer is a popular treatment modality in total root avulsed brachial plexus injury and also provides far better functional results as compared to tendon or muscle transfer and shoulder arthrodesis (Bertelli, ; Bertelli and Ghizoni, ; Chuang et al, ). A variety of differing nerve transfer sources have been discussed in the literature and utilized clinically.…”

Section: Discussionmentioning

confidence: 99%

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Repair of the musculocutaneous nerve using the vagus nerve as donor by helicoid end‐to‐side technique: an experimental study in rats

Yan

Shen

Thayer

et al. 2017

J of Neuroscience Research

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Although several donor nerves can be chosen to repair avulsed brachial plexus nerve injury, available nerves are still limited. The purpose of this study is to validate whether the vagus nerve (VN) can be used as a donor. Eighteen Sprague-Dawley male rats were divided into three groups (n = 6). The right musculocutaneous nerve (McN) was transected with differing subsequent repair. (1) HS-VN group: a saphenous nerve (SN) graft-end was helicoidally wrapped round the VN side (epi-and perineurium was opened) with a 30 ° angle, distal SN end was coapted to the McN with end-to-end repair. (2) EE-PN group: a SN was interpositionally grafted between the transected phrenic nerve (PN) and the McN by end-to-end coaptation. (3) Sham control group: McN was transected and not repaired and postoperative vital signs were checked daily. At three months, electrophysiology, tetanic force, wet biceps muscle weight, and histology were evaluated. Every tested mean value in HS-VN group was significantly greater than the EE-PN or the sham control groups (p < 0.05 or p < 0.005). The mean recovery ratio of regenerated nerve fibers was 96% and, in HS-VN group, the mean recovery ratio of CMAP was 79%. No vital signs changed in any group. There was no statistical difference (p > 0.5) between the mean VN nerve-fiber numbers of the segments proximal (2237 ± 134) and distal (2150 ± 156) to the VN graft-attachment site. Histological analysis revealed no axon injury or intraneural scarring at any point along the VN. This study demonstrated that VN is a practical and reliable donor nerve for end-to-side nerve transfer. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

“…Current treatments for BPI include neurolysis, nerve grafts, nerve transfer, and free‐muscle and pedicle‐muscle transfer. Of these, nerve transfer remains one of the most favored treatments for total root avulsion injuries (Bertelli, ; Bertelli and Ghizoni, ; Bhandari et al, ).…”

Section: Introductionmentioning

confidence: 99%

Repair of the musculocutaneous nerve using the vagus nerve as donor by helicoid end‐to‐side technique: an experimental study in rats

Yan

Shen

Thayer

et al. 2017

J of Neuroscience Research

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“…Interestingly, independent of the mechanism that ensures preserved sensation over the dorsoradial surface of the hand following a radial nerve injury, the accurate localization of delivered stimuli was a prominent finding in our patients. This differs from sensory reconstruction following nerve transfers, with which stimulus perception stems from the donor nerve (Bertelli & Ghizoni, ). Accurate locognosia was achieved either after light touch or the delivery of a noxious stimulus, in accordance with previous studies, which indicates that stimulus strength has limited influence on the accuracy of locognosia (Zigler, Moore, & Wilson, ).…”

Section: Discussionmentioning

confidence: 99%

“…According to the manufacturer (Sorri™, Bauru, Sao Paulo), the 0.05 and 2.0 monofilaments produce pressures of 1.45 and 19.3 g/mm 2 , respectively. Detection of the 0.05 monofilament corresponds to normal sensation, whereas detection of the 2.0 monofilament corresponds to light touch perception; lost perception of the 2.0 monofilament is the threshold at which we consider sensory reconstruction indicated (Bertelli & Ghizoni, ). We grasped the skin on the radial border of the hand with a flat Adson forceps to assess nociception, as reported elsewhere (Bertelli & Ghizoni, ).…”

Section: Patient and Methodsmentioning

confidence: 99%

Sensory deficits after a radial nerve injury

et al. 2017

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“…The donors are the nerves supplying less essential areas like the third web space (MN branch) the forth web space (UN branch), the dorsal sensory branch of the UN and the radial sensory nerve (RSN) [22,29,49,50,65,157,158]. Ducic et al [159] in 2006 recovered the sensation of the thumb and index fingers using the radial nerve branches as donors.…”

Section: Nerve Transfers For Upper Limb Sensation Recoverymentioning

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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Nerve transfer for sensory reconstruction of C8‐T1 dermatomes in tetraplegia

Abstract: Sensory nerve transfers should be incorporated into the reconstruction of the upper limb in tetraplegics. © 2015 Wiley Periodicals, Inc. Microsurgery 36:637-641, 2016.

Cited by 14 publications

References 22 publications

Repair of the musculocutaneous nerve using the vagus nerve as donor by helicoid end‐to‐side technique: an experimental study in rats

Repair of the musculocutaneous nerve using the vagus nerve as donor by helicoid end‐to‐side technique: an experimental study in rats

Sensory deficits after a radial nerve injury

Nerve Transfers in the Treatment of Peripheral Nerve Injuries

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