Intraoperative Decision Making by Electrophysiological Detection of the Origin of Thoracodorsal Nerve in the C7 Nerve Root Transfer Procedure

Abstract

The objective of this article is to discuss the significance of predicting the injury degree of the thoracodorsal nerve by intraoperative electrophysiological examination in the C7 nerve root transfer for brachial plexus injury. Each trunk of the brachial plexus followed by each bundle of C7 was stimulated before the contralateral C7 was disconnected. The ratio of the origination of thoracodorsal nerve controlling the latissimus dorsi muscle was evaluated. The highest ratio of the origination of thoracodorsal nerve controlling the latissimus dorsi muscle was in the middle trunk of the brachial plexus. In the middle trunk, the highest ratio was the posterior division. In the posterior division, the internal fascicles were the predominant ones. The intraoperative electrophysiological examination can precisely locate the origin of the dominated nerve of latissimus dorsi muscle. It is recommended for safety to direct the operative procedure selection in the C7 transfer.