Clinical evaluation of C7 spinal nerve transection: 21 patients with at least 2 years’ follow-up

Chuang, David Chwei‐Chin; Cheng, Shao-Lung; Wei, Fu‐Chan; Wu, Chia-Lun; Ho, Yat‐Sen

doi:10.1054/bjps.1997.0193

Cited by 69 publications

(56 citation statements)

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“…4,14,27,30,31,32,35 One of the possible reasons for this discrepancy was a difference in technique between studies; some authors performed hemi-CC7 nerve transfer to reduce donor-side morbidity. 27,30,32 Another reason may be related to the use of a verbal patient response to assess symptoms of the donor limb, which may have underestimated the extent of nerve damage.…”

Section: Discussionmentioning

confidence: 99%

“…For patients in Group 1 (n = 21), the duration of follow-up ranged from 6 months to 2 years, whereas patients in Group 2 (n = 20) all had more than 2 years of follow-up. Since many authors 4,14,22,27,30,32,38 have reported restoration of normal function in the donor limb within 6 months after CC7 nerve transfer surgery, only patients who had undergone surgery at least 6 months previously were included in the postoperative evaluation groups. Two years after surgery was regarded as the demarcation point between Group 1 and Group 2, because recovery of motor function is scarcely possible after this time point due to muscle fibrosis.…”

Section: Participantsmentioning

confidence: 99%

“…Nevertheless, it has also been reported 4,22,30,31 that a few patients experienced motor and/or sensory deficits in the donor limbs at 1.5 to 3 years postoperatively.…”

mentioning

confidence: 96%

“…This finding was similar to results obtained by Chuang and colleagues. 4,5 In the tip pinch test, patients in Group 2 showed significantly more strength than those in Group 1, which was related to greater use of the hand on the donor side in patients with brachial plexus injury.…”

mentioning

confidence: 97%

“…2,18,21,39 We also observed, however, that patients with motor weakness obtained satisfactory functional recovery with increased follow-up time, which was consistent with the findings of other researchers. 4,30,35 Functional deficits caused by nerve injuries can be compensated for by 3 neural mechanisms: reinnervation of denervated targets by regeneration of injured axons, reinnervation by collateral branching of undamaged axons, and remodeling of nervous system circuitry related to the lost function. Thus, some authors have suggested that a long follow-up period is necessary to determine whether adequate function has been recovered.…”

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confidence: 99%

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Donor-side morbidity after contralateral C-7 nerve transfer: results at a minimum of 6 months after surgery

Yang

Hou

et al. 2016

JNS

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OBJECT Donor-side morbidity associated with contralateral C-7 (CC7) nerve transfer remains controversial. The purpose of this study was to evaluate functional deficits in the donor limb resulting from prespinal route CC7 nerve transfer. METHODS A total of 63 patients were included. Forty-one patients had undergone CC7 nerve transfer surgery at least 6 months previously and were assigned to one of 2 groups based on the duration of postoperative follow-up. Group 1 (n = 21) consisted of patients who had undergone surgery between 6 months and 2 years previously, and Group 2 (n = 20) consisted of patients who had undergone surgery more than 2 years previously. An additional 22 patients who underwent CC7 nerve transfer surgery later than those in Groups 1 and 2 were included as a control group (Group 3). Results of preoperative testing in these patients and postoperative testing in Groups 1 and 2 were compared. Testing included subjective assessments and objective examinations. An additional 3 patients had undergone surgery more than 6 months previously but had severe motor weakness and were therefore evaluated separately; these 3 patients were not included in any of the study groups. RESULTS The revised Short-Form McGill Pain Questionnaire (SF-MPQ-2) was the only subjective test that showed a significant difference between Group 3 and the other 2 groups, while no significant differences were found in objective sensory, motor, or dexterity outcomes. The interval from injury to surgery for patients with a normal SF-MPQ-2 score in Groups 1 and 2 was significantly less than for those with abnormal SF-MFQ-2 scores (2.4 ± 1.1 months vs 4.6 ± 2.9 months, p = 0.002). The 3 patients with obvious motor weakness showed a tendency to gradually recover. CONCLUSIONS Although some patients suffered from long-term sensory disturbances, resection of the C-7 nerve had little effect on the function of the donor limb. Shortening preoperative delay time can improve sensory recovery of the donor limb.

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Section: Discussionmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

“…Nevertheless, it has also been reported 4,22,30,31 that a few patients experienced motor and/or sensory deficits in the donor limbs at 1.5 to 3 years postoperatively.…”

mentioning

confidence: 96%

mentioning

confidence: 97%

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confidence: 99%

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Donor-side morbidity after contralateral C-7 nerve transfer: results at a minimum of 6 months after surgery

Yang

Hou

et al. 2016

JNS

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Nerves of the Upper Extremity

Mahan

Spinner

2016

Bergman's Comprehensive Encyclopedia of Human Anatomic Variation

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Extensive somatosensory innervation in infants with obstetric brachial palsy

et al. 2002

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In the pre-operative screening of infants with obstetric brachial palsy (OBP), the results of routine electromyography are often overly optimistic when compared to the peri-operative findings. This prompted us to include investigation of the sensory innervation of these infants using the N20 (the first cortical response to a peripheral stimulation) of the somatosensory evoked potentials (SSEP). Three to seven months after birth, SSEP were recorded at the skull after stimulation of the thumb and middle finger in infants with obstetric rupture of the upper trunk or avulsion of roots C5, C6, or C7, and in whom no clinical improvement of motor function was observed in the biceps brachii and deltoid muscles. In most infants, a normal N20 could be evoked, indicating the existence of peripheral sensory pathways. From the thumb, these sensory pathways would necessarily bypass the upper trunk and dorsal roots of spinal nerves C5 and C6, and from the middle finger bypass the middle trunk and dorsal root C7, before extending into the dorsal column and projecting toward the thalamus and cerebral cortex. These data suggest that in infancy the segmental sensory innervation of the hand is more diverse than is described in most textbooks.

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Clinical evaluation of C7 spinal nerve transection: 21 patients with at least 2 years’ follow-up

Cited by 69 publications

References 0 publications

Donor-side morbidity after contralateral C-7 nerve transfer: results at a minimum of 6 months after surgery

Donor-side morbidity after contralateral C-7 nerve transfer: results at a minimum of 6 months after surgery

Nerves of the Upper Extremity

Extensive somatosensory innervation in infants with obstetric brachial palsy

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