Selective restoration of sensation by peripheral nerve grafts directly implanted into the contralateral C7 dorsal root ganglion: an experimental study in rat brachial plexus

Neurosurgery
J A BertelliL Kassar

Abstract

In brachial plexus injuries, when the dorsal root ganglion (DRG) is avulsed from the spinal cord there is no possibility of direct repair. Therefore, in the present report the median nerve was connected directly to the contralateral C7 DRG, to restore forepaw sensation. The ulnar nerve was sectioned, and a 15-mm segment of nerve was removed. The median nerve was sectioned, transposed dorsally, and repaired using a sural nerve graft directly implanted into the C7 contralateral DRG. Rats were then assessed 6 and 12 months later by behavioral, histological, and plasma extravasion techniques. All animals recovered sensation in the forepaw. Retrogradely labeled sensory neurons were demonstrated in the C7 DRG, and the whole forepaw was labeled after plasma extravasion induction by median nerve antidromic stimulation. Several myelinated and positively neurofilament-stained fibers were demonstrated in the grafted median nerve. The surgical strategy proposed might be a useful alternative to selective sensory repair in the emerging field of brachial plexus reconstruction by direct spinal cord surgery.

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Citations

Oct 5, 2002·Stroke; a Journal of Cerebral Circulation·S Claiborne JohnstonUNKNOWN Committee on Cerebrovascular Imaging of the American Heart Association Council on Cardiovascular Radiology
Sep 12, 2006·Journal of Neurosurgery. Spine·Pirjo RäsänenRisto P Roine
Dec 20, 2003·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·M LeonardiR Agati
Apr 28, 2005·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Býlge KaraUmýt Acar
Apr 6, 2006·Microsurgery·Jayme Augusto Bertelli, Marcos Flávio Ghizoni
Dec 20, 2008·Journal of Korean Neurosurgical Society·Young-Jin KimSuck Jun Oh
Jul 7, 2000·Journal of Neurosurgery·J A BertelliA Michels

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