Possible donor nerves for axillary nerve reconstruction in dual neurotization for restoring shoulder abduction in brachial plexus injuries: a systematic review and meta-analysis

Double Fascicular Nerve Transfer Restored Nearly Normal Functional Movements in a Completely Paralyzed Upper Extremity Resulting from an ACDF Surgery: A Case Report and Review of Recent Literature

“…Fasce et al [ 22 ] showed a mean of 135° in shoulder abduction with triple nerve transfers. In comparison to recently reported double nerve transfer procedures to reanimate shoulder abduction [ 14 , 22 ] or elbow flexion [ 23 ], as well as triple or multiple nerve transfers [ 21 , 22 ], our surgical outcome (double nerve transfers with neurolysis and muscle contracture release) was more effective, as it restored all UE functional movements (shoulder abduction and elbow flexion) to nearly normal ( Figure 2A–2C ).…”

“…Addressing nerve root injuries in the context of severe cervical spinal cord injuries resulting in complete paralysis of the extremities has been challenging. Distal-targeted nerve transfers have been successfully performed as a preferred alternative to the site of a proximal injury [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] since the regeneration distance will be much shorter and, therefore, the recovery will be faster. Additionally, in cases of iatrogenic surgical injuries at the proximal cervical spinal level (ACDF), as in the present case report, the distal operative area will have no scarring from previous surgeries, allowing for technical precision in reconstructive efforts.…”

“…The meta-analysis article by Makel et al [ 14 ] summarized the results of 15 articles on distal nerve transfer for brachial plexus injury. They compared the effectiveness of the radial nerve transfer to the intercostal nerve.…”

“…Uerpairojkit et al [ 15 ] used the spinal accessory and the radial nerve to the long head of the triceps. The intercostal nerve transfer is performed in cases of total brachial plexus injury or involvement of the C7 root [ 14 , 16 ]. The disadvantages of intercostal nerve transfers are the need for extensive preparation for harvesting them and the risk of iatrogenic pneumothorax [ 17 ].…”

Traumatic brachial plexus injury: diagnosis and treatment

“…If the SAN is not available, alternative donors include the motor nerve to the rhomboids and levator scapulae [24,25]. Intercostal nerves (ICNs), medial pectoral nerve, and median/ulnar fascicles can also be used as donors to the AN, when the triceps motor branches are not available [26]. Elbow flexion can be restored with either transfer of a median nerve or median nerve fascicle to the biceps and brachialis motor branches of the MCN Figure 4a [27,28].…”