Long-term outcome of selective contralateral C7 nerve transfer

Abstract

Objective To evaluate the long term outcome of patients treated with selective contralateral C7 transfer and to determine the factors affecting the outcomes of treatment. Methods Forty-six patients with total brachial plexus avulsion injuries were involved in this serial. All of the surgeries were performed by two stages and median nerve was the recipient nerve. Tne contralateral C7 nerve was used in three different ways. The whole root was used in eight patients; the major part except the anterior and medial part of the anterior division was used in 14 patients; the anterior or the posterior division was used in 24 patients. The functions of all the patients were evaluated by the British Medical Research Council (MRC) scale. Results The entire effective rate was 47.83% (22/46) in motor function and 56.52% (26/46) in sensory function. The more nerve fibers of C7 were used the better motor function were obtained. A better result of motor recovery could be induced if the interval between two stages was within four to eight months. And there seemed no statistically significant( P >0.05) in either motor or sensory function recovery with the difference of post trauma time. Conclusion Selective contralateral C7 transfer is an effective procedure in treating total brachial plexus avulsion injury. The more nerve fibers of C7 are used the better function recovery can be obtained and the ideal interval between two stages is four to eight months. The posttrauma time should be another key factor, and the surgery ought to be performed as early as possible. Key words: Brachial plexus; Median nerve; Follow-up studies; Contralateral C7; Selective repair