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01-12-2015 | Technical Note - Neurosurgical Techniques

Transdiscal C₆–C₇ contralateral C₇ nerve root transfer in the surgical repair of brachial plexus avulsion injuries

Authors: Vicente Vanaclocha, Juan Manuel Herrera, Francisco Verdu-Lopez, Laurabel Gozalbes, Moises Sanchez-Pardo, Marlon Rivera, Deborah Martinez-Gomez, Juan D. Mayorga

Published in: Acta Neurochirurgica | Issue 12/2015

Abstract

Background

Repair of complete brachial plexus avulsion injuries may require contralateral C₇ nerve root transfer. The available techniques might allow direct neuroraphy in about 50 % of cases but the others require interposing nerve grafts or humeral shaft shortening. We aimed to see if transdiscal C₆–C₇ contralateral C₇ nerve root transfer is technically feasible and if it allows direct coaptation with the contralateral nerve roots in 100 % of cases.

Methods

In ten fresh-frozen adult cadavers, the C₇ nerve root was sectioned just before it connects with other brachial plexus branches and re-routed though the C₆–C₇ disc space to the contralateral side. A complete C₆–C₇ discectomy was performed and the disc space kept open with the aid of an autologous iliac crest bone graft.

Results

Transdiscal C₆–C₇ contralateral C₇ nerve root transfer is technically feasible. In our cadavers, it provided 5.3 ± 1.2 SDcm of extra length that allowed direct coaptation with the contralateral nerve roots, mainly C₈ and T₁.

Conclusions

Transdiscal C₆–C₇ contralateral C₇ nerve root transfer is technically feasible. In our dissections it lengthens the available C₇ nerve root stump by 5.3 ± 1.2SDcm. The increase was 4 cm versus the retropharyngeal route making direct coaptation with the contralateral C₈ and T₁ nerve roots possible.

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Title: Transdiscal C6–C7 contralateral C7 nerve root transfer in the surgical repair of brachial plexus avulsion injuries
Authors: Vicente Vanaclocha
Juan Manuel Herrera
Francisco Verdu-Lopez
Laurabel Gozalbes
Moises Sanchez-Pardo
Marlon Rivera
Deborah Martinez-Gomez
Juan D. Mayorga
Publication date: 01-12-2015
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 12/2015
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-015-2596-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transdiscal C₆–C₇ contralateral C₇ nerve root transfer in the surgical repair of brachial plexus avulsion injuries

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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