The Effectiveness of Contralateral C7 Nerve Root Transfer for the Repair of Avulsed C7 Nerve Root in Total Brachial Plexus Injury: An Experimental Study in Rats

Abstract

The aim of this study was to evaluate the feasibility and effectiveness of transferring the contralateral C7 root to repair avulsed C7 nerve root. Thirty rats were randomized into three groups. In group A, rats underwent whole-root avulsion of the left brachial plexus and contralateral C7 root transfer to the avulsed C7 nerve root. In group B, rats underwent whole-root avulsion and contralateral C7 root transfer to the radial nerve. In group C, rats underwent whole-root avulsion of the left brachial plexus without nerve transfer. Functional outcomes were measured by electrophysiological studies, muscle tetanus contraction force, muscle mass, and histology. Six months postoperatively, increased amplitude and shortened latency of compound muscle action potentials, larger maximum tetanic contractile tension, heavier muscle mass, and larger cross-sectional area of the muscle fibers were observed in the triceps, extensor carpi radialis brevis, and extensor digitorum in groups A and B when compared with group C (p < 0.01). There were no significant differences between group A and B (p > 0.05). Contralateral C7 nerve transfer to repair avulsed C7 nerve root was feasible and effective in this rat model. It should be considered as an option for the treatment of brachial plexus injuries.

Microanatomy of the Separable Length of the C7

“…It increases the possibility of direct coaptation between the cC7 and the injured nerve. Moreover, clinical experience and experimental research demonstrated that this technique is safe and feasible, 20,23,24 and it may help improve the clinical outcomes of patients with brachial plexus avulsion.…”

C8 cross transfer for the treatment of caudal brachial plexus avulsion in three dogs

“…Various surgical techniques have been experimentally designed to treat BPA in people. These include avulsed spinal nerve root reimplantation into the spinal cord, neurotization of the plexus with either the phrenic nerves, the intercostal nerves, or the accessory nerves, cross transfer, and, more recently, C7‐cross‐transfer . The choice among these techniques for human patients remains controversial and depends on the exact location and extent of the avulsion.…”

“…We hypothesized that the poor results for surgical treatment of BPA in the dog could be improved by using an anastomosis between the avulsed part of the brachial plexus and the distal stump of a donor nerve. A technique of cross‐transfer, using the contralateral brachial plexus, has been described and applied in people . The C7 spinal nerve, collected on the healthy side, was anastomosed to the ulnar nerve in the affected limb.…”

Diagnostic Accuracy of Three Sensory Tests for Diagnosis of Sensory Disturbances

“…Third, sensation is a complex physiological and psychological processes; it is also related to the patient's cognitive state. Our patients suffered from brachial plexus injury, which is a serious problem in hand surgery, [34][35][36][37] and severity of the injured limb may affect the patient's judgment of sensation in the contralateral limb. Because of the complexity and range of manifestations observable in patients with sensory disturbances, Walk et al 1 had developed a comprehensive There are some limitations of the current study.…”