Nerve transfer is a validated surgical procedure for the functional restoration of nerve tissue after damage. To date, various nerve transfer procedures have been used for management of brachial plexus avulsion injuries in the upper extremity [1-3]. In cases of lumbosacral plexus avulsion where the donor nerve is limited, intercostal nerves often serve as the donor nerves [4,5]. However, the limited numbers of axons in the intercostal nerves are insufficient to reconstruct lower limb function effectively [6,7]. Therefore, it is imperative that the suitable donor nerves are identified.In 1986, Gu et al. [8] introduced the use of contralateral C7 nerve root transfer to repair a brachial plexus injury. The key factor required for this procedure is to ensure that severance of C7 nerve root does not affect function on the healthy side. The brachial plexus is made up of the ventral rami of C5, C6, C7, C8 and Tl [9]. The sacral plexus originates from L4, L5, SI, S2 and S3 nerve roots [10]. The formation of both plexuses is in a similar manner. C7 and SI roots are the central root of each plexus. Although it is unknown whether severance of SI nerve would affect the function of the lower extremity, the unaffected contralateral SI nerve may be a suitable novel donor nerve for the repair of lumbosacral plexus avulsion.Our previous experimental studies in monkeys have confirmed that the severing of lumbosacral plexus L6 nerve root, which is the counterparts of SI in humans, did not affect lower limb function [11]. Based on the preclinical results, we attempt to treat lumbosacral plexus avulsion by transfer of the contralateral unaffected SI nerve root. To the best of our knowledge, it was the first study that the functions of the healthy limb were evaluated after extradural SI nerve transection and the contralateral unaffected SI as the donor nerve to repair the lumbosacral plexus avulsion.
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