Combined contralateral C7 to C7 and L5 to S1 cross nerve transfer for treating limb hemiplegia after stroke

Yang, Fangyuan; Chen, Liwen; Wang, Haipeng; Zhang, Jionghao; Shen, Yun-Dong; Qiu, Yan‐Qun; Qu, Zhiwei; Li, Jie; Xu, Wendong

doi:10.1080/02688697.2021.1910764

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…Zudem wird auch beginnend an der unteren Extremität ein solches Verfahren mit einem Transfer des N. obturatorius eingesetzt [6]. Yang et al beschreiben zudem auch den kontralateralen Transfer der L5-zur S1 Wurzel zur Therapie der Hemiplegie in Folge eines Schlaganfalls in 2 Fällen, bei denen sie zudem auch gleichzeitig einen kontralateralen C7-Transfer durchführten [32]. Auch ein selektiver kontralateraler motorischer Nervenfaszikeltransfer zur Motorisierung eines freien funktionellen Muskeltransfers, im Sinne eines kontralateralen motorischen Pectoralis major Ast für einen freien Gracilis Transfer, wurde vor kurzem beschrieben [33].…”

Section: Neue Einsatzgebieteunclassified

Der kontralaterale C7 Transfer

Bahm,

Beier,

Schäfer

2024

Handchir Mikrochir Plast Chir

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ZusammenfassungKomplexe Verletzungen des Plexus brachialis mit multiplen oder vollständigen Ausrissen der Wurzeln machen in einigen Fällen eine Rekonstruktion unter Verwendung intraplexaler Spendernerven unmöglich. In solchen Fällen ist es erforderlich, dass man sich extraplexischer Nervenspender bedient, wie beispielsweise des N. accessorius oder der Intercostalnerven. Die kontralaterale C7-Wurzel stellt einen Spender mit einer hohen Axonzahl dar, die in solchen Fällen als Axonquelle herangezogen werden kann. Wir beschreiben die aktuelle Indikationsstellung, Operationstechnik und funktionelle Resultate nach einem kontralateralem C7-Transfer bei Plexusläsionen der oberen Extremität anhand eigener Fallbeispiele und einer spezifischen Literaturrecherche.

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Section: Neue Einsatzgebieteunclassified

Der kontralaterale C7 Transfer

Bahm,

Beier,

Schäfer

2024

Handchir Mikrochir Plast Chir

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“…Among the 22 reviewed studies, 19 (86.36%) provided level III evidence, and 21 (95.45%) obtained a low or very low score on the GRADE scale (Table 3) [39,40] (Figure 2). Sixteen studies were retrospective case series [12,17,18,[21][22][23][24][26][27][28][29][30][31][32][33]37], two were single-center [25] or multi-center [38] retrospective cohort studies, three were prospective case series [34][35][36], and one was a randomized controlled trial [16]. Only three studies included a comparative group, formed by patients who were treated with rehabilitation in two [16,38] and those undergoing a different surgical technique in the third [25].…”

Section: Quality Of Evidencementioning

confidence: 99%

“…The studies reported on a total of 965 upper extremities in 939 patients. The patient samples were heterogenous in all except two studies [37,38], comprising not only patients with stroke but also those with other etiologies of upper extremity spasticity, including traumatic brain injury and cerebral palsy. Stroke sequelae in the upper extremity was observed in 355 (37.80%) of the patients.…”

Section: Patient Profilementioning

confidence: 99%

Surgical Treatment in Post-Stroke Spastic Hands: A Systematic Review

Hurtado-Olmo,

González-Santos,

Pérez de Rojas

et al. 2024

JCM

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Background: For more than two decades, the surgical treatment of post-stroke spastic hands has been displaced by botulinum toxin therapy and is currently underutilized. Objectives: This article aimed to assess the potential of surgery for treating a post-stroke spastic upper extremity through a systematic review of the literature on surgical approaches that are adopted in different profiles of patients and on their outcomes and complications. Methods: Medline PubMed, Web of Science, SCOPUS, and Cochrane Library databases were searched for observational and experimental studies published in English up to November 2022. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluations (GRADE) system. Results: The search retrieved 501 abstracts, and 22 articles were finally selected. The GRADE-assessed quality of evidence was low or very low. The results of the reviewed studies suggest that surgery is a useful, safe, and enduring treatment for post-stroke spastic upper extremities, although most studied patients were candidates for hygienic improvements alone. Patients usually require an individualized combination of techniques. Over the past ten years, interest has grown in procedures that act on the peripheral nerve. Conclusions: Despite the lack of comparative studies on the effectiveness, safety, and cost of the treatments, botulinum toxin has displaced surgery for these patients. Studies to date have found surgery to be an effective and safe approach, but their weak design yields only poor-quality evidence, and clinical trials are warranted to compare these treatment options.

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“…The current rehabilitation methods for post-stroke spasm and limb movement disorders include rTMS and MRP ( 11 , 12 ). rTMS can influence the function and behavior of the cortex by safely modifying neuronal activity in certain brain areas ( 13 ). TMS uses Faraday's electromagnetic induction principle to generate an induced current in the brain.…”

Section: Introductionmentioning

confidence: 99%

Treatment effects of low-frequency repetitive transcranial magnetic stimulation combined with motor relearning procedure on spasticity and limb motor function in stroke patients

Chen,

Zhang,

Wang

et al. 2023

Front. Neurol.

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ObjectiveLimb paralysis, which is a sequela of stroke, limits patients' activities of daily living and lowers their quality of life. The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with a motor relearning procedure (MRP) on motor function and limb spasticity in stroke patients.MethodsStroke patients were randomly divided into a combined treatment group (rTMS + MRP) and a control group (MRP) (n = 30 per group). The control group was given MRP in addition to conventional rehabilitation, and the combined treatment group was given 1 Hz rTMS combined with MRP. The treatment efficacy was assessed by the modified Ashworth scale (MAS), Fugl-Meyer motor function scale, and motor evoked potential (MEP) testing.ResultsAfter 4 weeks of treatment, the Brunnstrom score, Fugl-Meyer lower extremity motor function, and Fugl-Meyer balance function were significantly higher in the combination treatment group compared to the control group, while the MAS score was lower in the combination treatment group compared to the control group. The MEP extraction rate was higher in the combined treatment group compared to the control group, while the threshold and central motor conduction time (CMCT) were lower in the combined treatment group compared to the control group.ConclusionLow-frequency rTMS combined with MRP had better efficacy on spasticity and motor function in stroke patients with hemiparesis than MRP alone.

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Combined contralateral C7 to C7 and L5 to S1 cross nerve transfer for treating limb hemiplegia after stroke

Cited by 9 publications

References 26 publications

Der kontralaterale C7 Transfer

Der kontralaterale C7 Transfer

Surgical Treatment in Post-Stroke Spastic Hands: A Systematic Review

Treatment effects of low-frequency repetitive transcranial magnetic stimulation combined with motor relearning procedure on spasticity and limb motor function in stroke patients

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