Summary: The authors retrospectively reviewed 44 patients who had sustained brachial plexus injuries with spinal nerve root avulsions. Surgical procedures included nerve grafts, nerve transfers, and in 8 cases early spinal re-implantation (in combination with “other” procedures). In the spinal re-implantation cases, motor recovery in the proximal limb was similar to that achieved by conventional nerve grafts and transfers.
Re-implantation of spinal nerve roots is a new surgical technique with a potential application in cases of multiple nerve root avulsions with limited donor nerves for transfer. The procedure is technically demanding, involving hemi-laminectomy, rotation of the spinal cord, and insertion of nerve grafts deep to the pia mater. The published reports are limited.
Brachial, Plexus, Spinal, Cord, Nerve, Root
J of Hand Surg