Assessment of the Results of Accessory to Suprascapular Nerve Transfer

Abdouni, Yussef Ali; Checoli, Gabriel Faria; Salles, Horacio Cardoso; Costa, Antonio Carlos da; Chakkour, Ivan; Fucs, Patrícia Maria de Moraes Barros

doi:10.1590/1413-785220182605193532

Cited by 4 publications

(13 citation statements)

References 8 publications

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“…In conclusion, clinicians may wish to exercise caution when considering the current surgical treatment of the transfer of the SAN for the suprascapular nerve. Studies in patients who did and did not receive nerve transfer have found no significant differences in external rotation of the arm 22 or in recovery of ROM or strength 23 ; postsurgical follow-ups have found no trapezius atrophy/weakness. 24 Motion systems, like the Motion Browser, can help clinicians better evaluate the native use of the trapezius muscle in BPBP patients before considering surgery.…”

Section: Discussionmentioning

confidence: 98%

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Lin

Chan

Silva

et al. 2021

J Brachial Plex Peripher Nerve Inj

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Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.

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Section: Discussionmentioning

confidence: 98%

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Lin

Chan

Silva

et al. 2021

J Brachial Plex Peripher Nerve Inj

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“…Today, most neurotization procedures for shoulder movements reactivation include an accessory nerve transfer to the suprascapular nerve to stabilize the shoulder and provide some external rotation, and the transfer of a radial nerve branch innervating the triceps muscle for the axillary nerve, reactivating deltoid contraction to resume shoulder abduction. Abdouni et al 12 demonstrated that isolated accessory nerve neurotization often has frustrating outcomes for shoulder function. In addition, the accessory nerve transfer prevents its future use in a free muscle flap neurotization.…”

Section: Discussionmentioning

confidence: 99%

“…Atualmente, as neurotizações mais usadas para reativar os movimentos do ombro são a transferência do nervo acessório para o nervo supraescapular, com o objetivo de estabilizar o ombro e dar algum grau de rotação externa ao mesmo, e a transferência de um dos ramos do nervo radial que inerva o músculo do tríceps para o nervo axilar, reativando a contração do músculo deltoide, e devolvendo assim a abdução do ombro. Abdouni et al 12 demonstraram que neurotização isolada do acessório tende a apresentar resultados frustrantes para a função do ombro. Além disso, a transferência do nervo acessório impossibilita usá-lo no futuro, em uma eventual neurotização de um retalho muscular livre.…”

Section: Discussionunclassified

“…3,8,10,11 Nas avulsões das raízes que formam o tronco superior, as opções para transferência nervosa são escassas, incluindo os nervos acessório, frênico e intercostais. Segundo Abdouni et al 12 e Malessy et al, 13 a transferência do nervo acessório para o nervo supraescapular, uma das mais realizadas na reconstrução do plexo braquial, tem algumas limitações já descritas na literatura.…”

Section: Introductionunclassified

“…3,8,10,11 Options for nerve transfer are scarce in cases with upper trunk roots avulsion, including accessory, phrenic and intercostal nerves. According to Abdouni et al 12 and Malessy et al, 13 accessory nerve transfer to the suprascapular nerve, a very common procedure for brachial plexus reconstruction, has some limitations described in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Transferência nervosa da raiz de C4 para C5 em lesões do plexo braquial. Estudo anatômico e descrição de técnica cirúrgica

Valeriano¹,

Abdouni²,

Costa³

2021

Rev Bras Ortop (Sao Paulo)

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Resumo Objetivo Estudo anatômico das raízes usadas na transferência nervosa de C4 para C5 nas lesões altas do plexo braquial, com demonstração da técnica cirúrgica. Métodos Dissecção de 15 plexos braquiais de cadáveres de ambos os sexos, registro e análise das características morfológicas das raízes de C4 e C5 e simulação de neurotização. Resultados As características morfológicas encontradas nas raízes de C4 e C5 em todas as dissecções permitiram a mobilização das mesmas e a realização de uma neurotização sem a necessidade de usar enxerto nervoso. A técnica cirúrgica permitiu preservar ramos nervosos importantes na região abordada. Conclusão Com base nos dados encontrados no presente estudo, podemos concluir que é possível realizar a transferência entre C4 e C5 sem provocar déficit neurológico adicional nas lesões altas de plexo braquial.

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A systematic review and meta‐analysis of patient‐reported outcomes following nerve transfer surgery for brachial plexus injury

Haldane

Frost

Ogalo

et al. 2022

PM&R

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Objective The purpose of this systematic review and meta‐analysis was to determine the effect of nerve transfer surgery for brachial plexus injury (BPI) on patient‐reported outcomes. Literature Survey MEDLINE, EMBASE, and CINAHL were searched and screened in duplicate for relevant studies on September 25, 2019 and repeated June 24, 2020. Methodology The patient population included male and female patients who received nerve transfer surgery for BPI. Further inclusion criteria were: (1) all levels of evidence; (2) published in English; (3) conducted in humans; and (4) report of patient‐reported outcome. Two reviewers independently abstracted data regarding injury type, surgical technique, surgical timing, follow‐up duration, strength, and patient‐reported outcome measures. Quality was assessed in duplicate using the Methodological Index for Non‐Randomized Studies criteria. Synthesis Twenty‐one studies involving 464 participants were included in analyses. The mean age ± SD was 32.4 ± 1.8 (range: 5–77) and 89.2% of included participants were male. The mean time to surgery was 5.6 ± 0.6 months and the mean follow‐up time was 48.1 ± 8.4 months. The most used patient‐reported outcome was the Disabilities of Arm, Shoulder and Hand (DASH), where scores variably improved postoperatively, although the degree of disability remained high. Return to work was reported in five studies, with 66.0% of participants returning to work. Patient satisfaction was assessed in four studies with an overall satisfaction proportion of 64.0%. Pain was assessed in 12 studies using various measures. In studies reporting pain intensity postoperatively, 29.3% of patients were “pain‐free” or had “no pain.” Conclusions Patient‐reported outcomes following nerve transfer for BPI are infrequently reported in the literature. Although patient‐reported outcomes demonstrate variable postoperative improvement, there is evidence of ongoing limitations and postoperative DASH scores report a high degree of ongoing disability. Future studies with greater reporting as well as validation of patient‐reported outcomes within BPI are warranted.

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Assessment of the Results of Accessory to Suprascapular Nerve Transfer

Cited by 4 publications

References 8 publications

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Transferência nervosa da raiz de C4 para C5 em lesões do plexo braquial. Estudo anatômico e descrição de técnica cirúrgica

A systematic review and meta‐analysis of patient‐reported outcomes following nerve transfer surgery for brachial plexus injury

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