End-to-side Neuroraphy in Treatment of Brachial Plexus Injury
| Authors | |
|---|---|
| Year of publication | 2005 |
| Type | Article in Proceedings |
| Conference | Spine and Peripheral Nerves |
| MU Faculty or unit | |
| Citation | |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | spinal nerve; nerve injury |
| Description | Introduction: Despite of the progress in peripheral nerve surgery, the positive results in peripheral nerve reconstruction in some locations remain difficult to achieve. Methods: During the past five years 17 patients have been operated on with avulsion of C5-7 spinal roots using the technique of end-to-side neuroraphy. Fifteen patients were male and two female, mean age was 28 years. The recipient nerve was axillary nerve in 14 cases, spinal roots in one case, both musculocutaneous and ulnar nerves in 1 case. As the donor nerve we have used in 8 interventions ulnar nerve, in 6 median nerve, in 2 radial nerve and in 1 intervention roots C5 and C6. In experimental study we sutured the distal stump of a transected musculocutaneous nerve to an intact ulnar nerve of the rat in an end-to-end fashion. We demonstrated the formation of collateral sprouts from intact afferent and motor axons by application of one type of molecule conjugated by two different fluorophores. Results: Of the 12 patients with the follow up longer than 24 months, 9 patients (75%) were successful (fair and good results), while 3 of them (25%) were unsuccessful. Eleven patients achieved electrophysiological signs of reinnervation. The mean muscle strength in the group of successful patients was 3.7. Our experimental results unequivocally demonstrate that a nerve stump attached to an intact nerve can induce collateral sprouting of both afferent and motor axons. Conclusions: Our results demonstrate that the end-to-side anastomosis of the peripheral nerve might be successfully used for reinnervation procedures of brachial plexus injury. |
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