A novel strategy for repairing preganglionic cervical root avulsion in brachial plexus injury by sural nerve grafting

Journal of Neurosurgery
Jau-Ching WuHenrich Cheng

Abstract

In this study, the authors evaluated the efficacy of a new surgical strategy for reconnecting the injured brachial plexus with the spinal cord using fibrin glue containing acidic fibroblast growth factor as an adhesive and neurotrophic agent. Eighteen patients with preganglionic brachial plexus injuries, each with varying degrees of upper limb dysfunction, underwent cervical laminectomy with or without sural nerve grafting. The treatment of each avulsed root varied according to the severity of the injury. Some patients also underwent a second-stage operation involving supraclavicular brachial plexus exploration for reconnection with the corresponding segment of cervical spinal cord at the trunk level. Muscle strength was graded both pre- and postoperatively with the British Medical Research Council scale, and the results were analyzed with the Friedman and Wilcoxon signed-rank tests. Muscle strength improvements were observed in 16 of the 18 patients after 24 months of follow-up. Significant improvements in mean muscle strength were observed in patients from all repair method groups at 12 and 24 months postoperatively (p < 0.05). Statistical significance was not reached in the groups with insufficient numbers of cases. The auth...Continue Reading

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Citations

Jan 6, 2010·Plastic and Reconstructive Surgery·Julia K Terzis, Antonia Barmpitsioti
Jun 15, 2011·Journal of Neurosurgery. Spine·Michael G Fehlings, Jefferson R Wilson
Jun 15, 2011·Journal of Neurosurgery. Spine·Jau-Ching WuHenrich Cheng
Sep 30, 2015·The European Journal of Neuroscience·Ruben EggersJoost Verhaagen
Jan 18, 2019·Neurospine·Chin-Chu KoHenrich Cheng
Dec 2, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Zhen-Xiang WangShi-Rong Li
May 2, 2021·Annals of Anatomy = Anatomischer Anzeiger : Official Organ of the Anatomische Gesellschaft·Robert SteelePhilip Brauer

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