The intercostal nerve as a target for diagnostic biopsy

Journal of Neurosurgery
Khoi D NguyenSamuel D Macomson

Abstract

OBJECTIVE Peripheral nerve biopsy is a useful tool in diagnosing peripheral neuropathies. Sural and gracilis nerves have become the most common targets for nerve biopsy. However, the yield of sural nerve biopsy is limited in patients who have motor neuropathies, and gracilis nerve biopsy presents technical challenges and increased complications. The authors propose the intercostal nerve as an alternative motor nerve target for biopsy. METHODS A total of 4 patients with suspected peripheral neuropathies underwent intercostal nerve biopsy at the authors' institution. A rib interspace that is inferior to the pectoralis muscle and anterior to the anterior axillary line is selected for the procedure. Generally the lower intercostal nerves (i.e., T7-11) are targeted. An incision is made over the inferior aspect of the superior rib at the chosen interspace. Blunt dissection is carried down to the neurovascular bundle and the nerve is isolated, ligated, and cut to send for pathological examination. RESULTS The average operative time for all cases was 73 minutes, with average blood loss of 8 ml. Biopsy results from 1 patient exhibited axonopathy, and the other 3 patients demonstrated axonopathy with demyelination. There were no short- o...Continue Reading

References

Jul 1, 1997·Journal of Neurosurgery·M K AbouzahrM Corbo
Jan 22, 1998·Journal of Neurology, Neurosurgery, and Psychiatry·D S MolenaarR de Haan
Sep 16, 2000·Journal of Neurology, Neurosurgery, and Psychiatry·C M GabrielR A Hughes
Feb 1, 2011·Annals of Neurology·Nilo RivaAngelo Quattrini
Jul 24, 2013·World Journal of Orthopedics·Marios G LykissasAlexandros E Beris

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