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The Egyptian Journal of Plastic and Reconstructive Surgery
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Volume Volume 42 (2018)
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Issue Issue 1
Ahmad, M. (2018). Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy. The Egyptian Journal of Plastic and Reconstructive Surgery, 42(1), 67-74. doi: 10.21608/ejprs.2018.215066
Mohammad Reda Ahmad. "Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy". The Egyptian Journal of Plastic and Reconstructive Surgery, 42, 1, 2018, 67-74. doi: 10.21608/ejprs.2018.215066
Ahmad, M. (2018). 'Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy', The Egyptian Journal of Plastic and Reconstructive Surgery, 42(1), pp. 67-74. doi: 10.21608/ejprs.2018.215066
Ahmad, M. Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy. The Egyptian Journal of Plastic and Reconstructive Surgery, 2018; 42(1): 67-74. doi: 10.21608/ejprs.2018.215066

Safety of the Prevertebral Approach for Cross C7 Transfer in Traumatic Brachial Plexus Palsy

Article 11, Volume 42, Issue 1, January 2018, Page 67-74  XML PDF (25.85 MB)
Document Type: Original Article
DOI: 10.21608/ejprs.2018.215066
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Author
Mohammad Reda Ahmad*
The Plastic and Reconstructive Surgery Unit, Faculty of Medicine, Zagazig University, Zagazig
Abstract
Introduction: High disability present in traumatic brachial
plexus palsy with total nerve root avulsion, as nothing left
for intra plexus repair. Nerve transfer from nearby donors has
a disadvantage of having a low number of myelinated fibers
to innervate totally avulsed plexus. Using cross C7 (CC7)
could add more donor myelinated fibers to solve this problem.
The Aim of Study: Is to assess the safety of pre-vertebral
approach (retro-esophageal) in comparison with a subcutaneous
tunnel by using vascularized ulnar nerve graft (VUNG).
Patients and Methods: Nineteen patients with total nerve
root avulsion were divided according to the operative procedure
into two groups: Prevertebral approach for turned on cross
C7 (group I), and subcutaneous tunnel with VUNG (group < br />II).
Results: No significance difference could be detected
between group I and group II regarding the mean value of
shoulder motor recovery, elbow motor recovery, hand motor
recovery, hand sensation, or follow-up period. However, the
duration of surgery in group I was significantly lower and the
hospital stay was significantly shorter than that of group II.
Moreover, the incidence postoperative complications were
higher in group II.
In Conclusion: Cross C7 can be done through subcutaneous
approach with VUNG or through pre-vertebral retroesophageal
approach. Pre-spinal retro-esophageal approach
is safer, easy, and protected tunnel for CC7 transfer to lower
plexus avulsion neuritization.
Keywords
Cross C7; Brachial plexus; Prevertebral; retro-esophageal; Vascularized ulnar
Main Subjects
Trauma
References
Gu Y.D., Zhang G.M., Chen D.S., Yan J.G., Cheng X.M.
and Chen L.: Seventh cervical nerve root transfer from
the contralateral healthy side for treatment of brachial
plexus root avulsion. J. Hand Surg. Br., 17: 518-521,
1992.
2- Tu Y.K. and Chung K.C.: Surgical procedures for recovery
of hand function. In: Chung K.C., Yang L.J.S., McGillicuddy
J.E., editors. Practical management of pediatric
and adult brachial plexus palsies. Saunders Elsevier, New
York, p 271-300, 2012.
3- Songcharoen P., Wongtrakul S., Mahaisavariya B. and
Spinner R.J.: Hemicontralateral C7 transfer to median
nerve in the treatment of root avulsion brachial plexus
injury. J. Hand Surg. Am., 26: 1058-1064, 2001.
4- Bertelli J.A. and Ghizoni M.F.: Transfer of a flexor
digitorum superficialis motor branch for wrist extension
reconstruction in C5-C8 root injuries of the brachial
plexus: A case series. Microsurgery, 33: 39-42, 2013.
5- Doi K., Muramatsu K. and Hattori Y.: Restoration of
prehension with the double free muscle technique following
complete avulsion of the brachial plexus. J. Bone
Joint Surg. Am., 82: 652-666, 2000.
6- Terzis J.K., Kokkalis Z.T. and Kostopoulos E.: Contralateral
C7 transfer in adult plexopathies. Hand Clin., 4:
389-400, 2008.
7- Doi K., Hattori Y., Kuwata N., Soo-heong T., Kawakami
F., Otsuka K. and Watanabe M.: Free muscle transfer can
restore hand function after injuries of the lower brachial
plexus. J. Bone Joint Surg. (Br.), 80: 117-120, 1998.
8- Emmelot C.H., Nielsen H.K. and Eisma W.H.: Shoulder
fusion for paralyzed upper limb. Clin. Orthop., 340: 95-
97, 1997.
9- Ruhmann O., Gosse F., Wirth C.J. and Schmolke S.:
Reconstructive operations for the paralyzed shoulder in
brachial plexus palsy: Concept of treatment. Injury, 30:
609-610, 1999.
10- Waikakul S., Orapin S. and Vanadurongwan V.: Clinical
results of contra-lateral C7 root neurotization to the median
nerve in brachial plexus injuries with total root avulsions.
J. Hand Surg. Br., 24: 556-560, 1999.
11- Terzis J.K. and Kostopoulos V.K.: The surgical treatment
of brachial plexus injuries in adults. Plast. Reconstr. Surg.,
119: 73e-92e, 2007.
12- Sammer D.M., Kircher M.F., Bishop A.T., Spinner R.J.,
and Shin A.Y.: Hemi-contralateral C7 transfer in traumatic
brachial plexus injuries: Outcome and complications. J.
Bone Joint Surg. Am., 94: 131-137, 2012.
13- El-Hoseny A.Y., Ahmed M. Reda and Hussein Y: New
proposed prevertebral approach for turned on normal
contralateral C7 as a donor for avulsed brachial Plexus;
Journal of American Science, 7 (4): 661-668, 2011.
14- Chuang D.C. and Hernon C.: Minimum 4-year follow-up
on contralateral C7 nerve transfers for brachial plexus
injuries. J. Hand Surg. Am., 37: 270-276, 2012.
15- Chuang D.C., Cheng S.L., Wei F.C., Wu C.L. and Ho
Y.S.: Clinical evaluation of C7 spinal nerve transaction:
21 patients with at least 2 years follow-up. Br. J. Plast.
Surg., 51: 285-290, 1998.
16- Gu Y.D., Chen D.S., Zhang G.M., Cheng X.M., Xu J.G.,
Zhang L.Y., Cai P.Q. and Chen L.: Long-term functional
results of contralateral C7 transfer. J. Reconstr. Microsurg.,
14: 57-59, 1998.
17- McGuiness C.N. and Kay S.P.J.: The prespinal route in
contralateral c7 nerve root transfer for brachial plexus
avulsion injuries Journal of Hand Surgery (Br.), 27B: 2:
159-160, 2002.
18- Goubier J.N., Teboul F. and Khalifa H.: Reanimation of
elbow extension with intercostal nerves transfers in total
brachial plexus palsies. Microsurgery, 31: 7-11, 2011.
19- Hierner R. and Berger A.K.: Did the partial contralateral
C7-transfer fulfill our expectations? Results after 5 year
experience. Acta. Neurochir., 100: 33-35, 2007.
20- Wang L., Zhao X., Gao K., Lao J. and Gu Y.D.: Reinnervation
of thenar muscle after repair of total brachial plexus
avulsion injury with contralateral C7 root transfer: Report
of five cases. Microsurgery, 31: 323-326, 2011.
21- Wang S., Yiu H.W., Li P., Li Y., Wang H. and Pan Y.:
Contralateral C7 nerve root transfer to neurotize the upper
trunk via a modified prespinal route in repair of brachial
plexus avulsion injury. Microsurgery, 32: 183-188, 2012.
22- Bonnard C. and Anastakis D.I.: Complete palsy. In: Alain
Gilbert, editor. Brachial plexus injuries. London: Martin
Dunitz, p 67-75, 2001.
23- Narakas A.O. and Hentz V.R.: Neurotization in brachial
plexus injuries. Indication and results. Clin. Orthop. Relat.
Res., 237: 43-56, 1988.
24- Merrell G.A., Barrie K.A., Katz D.L. and Wolfe S.W.:
Results of nerve transfer techniques for restoration of
shoulder and elbow function in the cortex of a metaanalysis
of the English literature. J. Hand Surg. Am., 26:
303-314, 2001.
25- Sananpanich K., Tu Y.K., Pookhang S. and Chalidapong
P.: Anatomical variance in common vascular pedicle of
the gracilis and adductor longus muscles: Feasibility of
double functioning free muscle trans-plantation with
single pedicle anastomosis. J. Reconstr. Microsurg., 24:
231-238, 2008.
26- Chen L. and Gu Y.D.: An experimental study of contralateral
C7 root transfer with vascularized nerve grafting
to treat brachial plexus root avulsion. J. Hand Surg. Br.,
19: 60-66, 1994.
27- Gu Y.D. and Shen L.Y.: Electrophysiological changes
after severance of the C7 root. J. Hand Surg Br., 19: 69-
71, 1994.
28- Liu J., Pho R.W., Kour A.K., Zhang A.H. and Ong B.K.:
Neurological deficit and recovery in the donor limb
following cross-C7 transfer in brachial-plexus injury. J.
Reconstr Microsurg., 13: 237-243, 1997.
29- Terzis J.K. and Kokkalis Z.T.: Selective contralateral C7
transfer in post-traumatic brachial plexus injuries: A
report of 56 cases. Plast. Reconstr. Surg., 123: 927-938,
2009.
30- Millesi H.: Update on the treatment of adult brachial
plexus injuries. In: Alain Gilbert, editor. Brachial plexus
injuries. London: Martin Dunitz, p 77-90, 2001.
31- Gu Y.D., Zhang G.M., Chen D.S., et al.: Cervical nerve
root transfer from contralateral normal side for treatment
of brachial plexus root avulsions. Chinese Medical Journal,
104: 208-211, 1991.
74 Vol. 42, No. 1 / Safety of the Prevertebral Approach for Cross C7 Transfer
32- Lu J., Xu J, Xu W., Xu L., Fang Y., Chen L. and Gu Y.:
Combined nerve transfers for repair of the upper brachial
plexus injuries through a posterior approach. Microsurgery,
32: 111-117, 2012.
33- Lin H., Lv D., Hou C. and Chen D.: Modified C-7 neurotization
in the treatment of brachial plexus avulsion injury.
J. Neurosurg., 115: 865-869, 2011.
34- Bentolila V., Nizard R., Bizot P. and Sedel L.: Complete
traumatic brachial plexus palsy. Treatment and outcome
after repair. J. Bone Joint Surg. Am., 81: 20-28, 1999.
35- Jerome J.T. and Rajmohan B.: Axillary nerve neurotization
with the anterior deltopectoral approach in brachial plexus
injuries. Microsurgery, 32: 445-451, 2012

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