A Clinical Analysis of Repairing the Whole Brachial Plexus Nerve Root Avulsion by Transferring C7 Nerve Root from the Uninjured Side

Abstract

Objective to perform a C7 transfer from the uninjured side for the patients with whole brachial plexus nerve root avulsion, conduct follow-up observations of the recovery conditions of the affected limb, and discuss the degree of the effect on the limb on the uninjured side and the mechanism. Method The 36 patients with whole brachial plexus nerve avulsion who received a C7 transfer from the uninjured side for repair by stages from January 2011-December 2011 in our hospital were selected as the objects to analyse the data of cases, carry out follow-up visits, evaluate of the limb functions on the uninjured side, and make comprehensive assessment in accordance with U.K. MRC scale for sensation and U.K. amended MRC scale for muscular strength. Result The follow-up visit results regarding the motor functions of the affected limb have indicated that there were 2 patients with effective recovery of supraspinatus muscular strength, 2 patients with effective recovery of deltoid muscular strength, 6 patients with effective recovery of biceps brachii muscular strength, 7 patients with effective recovery of triceps brachii muscular strength, 4 patients with effective recovery of extensor carpi muscular strength, and 5 patients with effective recovery of flexor carpi and flexor digitorum muscular strength. There were 7 patients whose latissimus dorsi muscular strength reached M5-, 7 patients whose triceps brachii muscular strength reached M5-, and 10 patients whose extensor digitorum muscular strength reached M5-6 months after operation. There were 3 patients whose limb on the uninjured side reached Sensation Grade S4, 12 patients whose limb on the uninjured side reached Sensation Grade S3+, 11 patients whose limb on the uninjured side reached Sensation Grade S3, and 10 patients whose limb on the uninjured side reached Sensation Grade S2 3 days after operation. The sensory functions of the majority of the patients recovered to S4 and their two-point discrimination approximately recovered to normal at the follow-up visit 1 year after operation. Conclusion Repair with C7 transfer from the uninjured side is currently an effective and feasible method to repair the functions of the affected limb in brachial plexus nerve root avulsion.