A Clinical Analysis of Repairing the Whole Brachial Plexus Nerve Root Avulsion by Transferring C7 Nerve Root from the Uninjured Side

摘要

The aim of this study is to perform a C7 transfer from the uninjured side for the patients with whole brachial plexus nerve root avulsion, and observe the recovery outcomes of affected limb. The 36 patients with whole brachial plexus nerve avulsion who received a C7 transfer from uninjured side for repair by stages were selected. Carrying out follow-up visits, evaluating limb functions on uninjured side, and making comprehensive assessment were in accordance with U.K. MRC scale for sensation and U.K. amended MRC scale for muscular strength. The results indicated that there were 2 patients with effective recovery of supraspinatus muscular strength, 2 of deltoid muscular strength, 6 of biceps brachii muscular strength, 7 of triceps brachii muscular strength, 4 of extensor carpi muscular strength, and 5 of flexor carpi and flexor digitorum muscular strength. Six months after operation, there were 7 patients whose latissimus dorsi muscular strength reached M5-, 7 triceps brachii muscular strength reached M5-, and 10 extensor digitorum muscular strength reached M5-. Three days after operation, there were 3 patients whose limb on uninjured side reached Sensation Grade S4, 12 reached Grade S3+, 11 reached Grade S3, and 10 reached Grade S2. Majority of patients recovered to sensory function S4 and their two-point discrimination approximately recovered to normal 1 year after operation. In conclusion, repair with C7 transfer from the uninjured side is currently an effective and feasible method to repair the functions of the affected limb in brachial plexus nerve root avulsion.