C7 transfer in a posterior intradural approach for treating hemiplegic upper-limbs: hypothesis and a cadaver feasibility study

Su, Jian; Chen, Wei; Shen, Yun-Dong; Qiu, Yan‐Qun; Yu, Ai-Ping; Xu, Wendong

doi:10.1080/02688697.2018.1552754

Cited by 7 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…End-to-end anastomosis without tension is still the gold standard in microsurgical nerve repair. However, the difficulties of nerve anastomosis will be exacerbated when the proximal stump of the injured nerve is surgically inaccessible to the distal nerve stump of the targeted muscle 46 . A nerve graft will be a must in this condition if the traditional end-to-end anastomosis is used.…”

Section: Resultsmentioning

confidence: 99%

“…However, an end-to-side anastomosis that coaptates the distal stump of the injured nerve to the lateral side of an adjacent uninjured nerve can be an effective alternative. Besides, as new surgical strategies such as contralateral C7 nerve root transfer via pre-spinal or retro-spinal route and others have been reported in recent years, corresponding rehabilitation of various kinds, including electrical stimulation (ES), are in high demand in clinical practice 46 , 47 .…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Integrated opposite charge grafting induced ionic-junction fiber

Xing

Zhou

et al. 2023

Nat Commun

Self Cite

View full text Add to dashboard Cite

The emergence of ionic-junction devices has attracted growing interests due to the potential of serving as signal transmission and translation media between electronic devices and biological systems using ions. Among them, fiber-shaped iontronics possesses a great advantage in implantable applications owing to the unique one-dimensional geometry. However, fabricating stable ionic-junction on curved surfaces remains a challenge. Here, we developed a polyelectrolyte based ionic-junction fiber via an integrated opposite charge grafting method capable of large-scale continuous fabrication. The ionic-junction fibers can be integrated into functions such as ionic diodes and ionic bipolar junction transistors, where rectification and switching of input signals are implemented. Moreover, synaptic functionality has also been demonstrated by utilizing the fiber memory capacitance. The connection between the ionic-junction fiber and sciatic nerves of the mouse simulating end-to-side anastomosis is further performed to realize effective nerve signal conduction, verifying the capability for next-generation artificial neural pathways in implantable bioelectronics.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Integrated opposite charge grafting induced ionic-junction fiber

Xing

Zhou

et al. 2023

Nat Commun

Self Cite

View full text Add to dashboard Cite

show abstract

“…Surgical advancements in contralateral C7 nerve transfer have progressed through anatomical research, favoring the prespinal route optimized by MRI guidance for its shorter regeneration path and avoidance of nerve grafting 44 , 73 . While a posterior spinal route could potentially reduce regeneration distance, it is less commonly used due to the risk of greater trauma, underscoring the preference for the prespinal approach in clinical practice 47 , 49 , 50 , 74 , 75 . As more patients undergo contralateral C7 nerve transfer, unexpected benefits are observed.…”

Section: Discussionmentioning

confidence: 99%

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

Xiang,

Wu,

et al. 2024

International Journal of Surgery

View full text Add to dashboard Cite

Background: The review highlights recent advancements and innovative uses of nerve transfer surgery in treating dysfunctions caused by central nervous system (CNS) injuries, with a particular focus on spinal cord injury (SCI), stroke, traumatic brain injury, and cerebral palsy. Methods: A comprehensive literature search was conducted regarding nerve transfer for restoring sensorimotor functions and bladder control following injuries of spinal cord and brain, across PubMed and Web of Science from January 1920 to May 2023. Two independent reviewers undertook article selection, data extraction, and risk of bias assessment with several appraisal tools, including the Cochrane Risk of Bias Tool, the JBI Critical Appraisal Checklist, and SYRCLE’s ROB tool. The study protocol has been registered and reported following PRISMA and AMSTAR guidelines. Results: Nine hundred six articles were retrieved, of which 35 studies were included (20 on SCI and 15 on brain injury), with 371 participants included in the surgery group and 192 in the control group. These articles were mostly low-risk, with methodological concerns in study types, highlighting the complexity and diversity. For SCI, the strength of target muscle increased by 3.13 of Medical Research Council grade, and the residual urine volume reduced by more than 100 ml in 15 of 20 patients. For unilateral brain injury, the Fugl-Myer motor assessment (FMA) improved 15.14–26 score in upper extremity compared to 2.35–26 in the control group. The overall reduction in Modified Ashworth score was 0.76–2 compared to 0–1 in the control group. Range of motion (ROM) increased 18.4–80° in elbow, 20.4–110° in wrist and 18.8–130° in forearm, while ROM changed −4.03°−20° in elbow, −2.08°−10° in wrist, −2.26°−20° in forearm in the control group. The improvement of FMA in lower extremity was 9 score compared to the presurgery. Conclusion: Nerve transfer generally improves sensorimotor functions in paralyzed limbs and bladder control following CNS injury. The technique effectively creates a ‘bypass’ for signals and facilitates functional recovery by leveraging neural plasticity. It suggested a future of surgery, neurorehabilitation and robotic-assistants converge to improve outcomes for CNS.

show abstract

“…To resolve the above limitations, Guan and colleagues developed a modified postspinal approach, thereby leading to lower spastic and better sensory function by short-term follow-up after operation. 24,25 In 2019, Jiang et al 26 were the first to describe a posterior intradural approach in their cadaver feasibility study.…”

Section: Discussionmentioning

confidence: 99%

A Cadaver Feasibility Study of Extradural Contralateral C7 Ventral Root Transfer Technique for Treating Upper Extremity Paralysis

Chang

Wang

et al. 2022

Spine

View full text Add to dashboard Cite

Study Design. A total of 6 formalin-fixed cadavers were included in the cadaver feasibility study.Objective. The aim was to ascertain the anatomical feasibility of extradural contralateral C7 ventral root transfer technique by cervical posterior. Summary of Background Data. Upper limb spastic hemiplegia is a common sequela after stroke. In our previous study, the authors established a method by transferring contralateral C7 dorsal and ventral roots to the corresponding C7 dorsal and ventral roots on the affected side in the cervical posterior. Methods. In the present study, six formalin-fixed cadavers were dissected to confirm the anatomical feasibility. Experimental anastomosis in cadavers was conducted. The pertinent lengths of the extradural nerve roots were measured. The tissue structures surrounding regions between the extradural CC7 nerve roots and the vertebral artery were observed. The cervical magnetic resonance imaging scans of 60 adults were used to measure the distance between the donor and recipient nerves. Results. Experimental anastomosis showed that the distance between the donor and recipient nerves was approximately 1 cm; the short segment of the sural nerve needed bridging. The distance between both exit sites of the exit of the extradural dura mater was 33.57 ± 1.55 mm. The length of the extradural CC7 ventral root was 22.00 ± 0.98 mm. The ventral distance (vd) and the dorsal distance (dd) in males were 23.98 ± 1.72 mm and 30.85 ± 2.22 mm (P < 0.05), while those in females were 23.28 ± 1.51 mm and 30.03 ± 2.16 mm, respectively. C7 vertebral transverse process, ligaments, and other soft tissues were observed between the vertebral artery and the extradural C7 nerve root. Conclusion. Under the premise of less trauma, our study shows that the extradural contralateral C7 ventral root transfer technique, in theory, yields better surgical results, including better recovery of motor function and complete preservation of sensory function.

show abstract

C7 transfer in a posterior intradural approach for treating hemiplegic upper-limbs: hypothesis and a cadaver feasibility study

Cited by 7 publications

References 21 publications

Integrated opposite charge grafting induced ionic-junction fiber

Integrated opposite charge grafting induced ionic-junction fiber

Peripheral nerve transfers for dysfunctions in central nervous system injuries: a systematic review

A Cadaver Feasibility Study of Extradural Contralateral C7 Ventral Root Transfer Technique for Treating Upper Extremity Paralysis

Contact Info

Product

Resources

About