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Motor Recovery and the Breathing Arm after Brachial Plexus Surgical Repairs, Including Re-Implantation of Avulsed Spinal Roots into the Spinal Cord

Author(s): Htut M, Misra VP, Anand P, Birch R, Carlstedt T

Source: J Hand Surg 32E: 2:170-178.

Summary:

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