Comparison between direct repair and humana cellular nerve allografting during contralateral C7 transfer to the upper trunk for restoration of shoulder abduction and elbow flexion
|
摘要
Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system; meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83%and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China(Application ID: [2017] 290) on November 14, 2017.
Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system; meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83%and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China(Application ID: [2017] 290) on November 14, 2017.
Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system; meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83%and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restoration of shoulder abduction and elbow flexion. Thus, if direct coaptation is not possible, use of acellular nerve allografts is a suitable option. This study was approved by the Medical Ethical Committee of the First Affiliated Hospital of Sun Yat-sen University, China(Application ID: [2017] 290) on November 14, 2017.
引文
Baltzer HL,Wagner ER,Kircher MF,Spinner RJ,Bishop AT,Shin AY(2017)Evaluation of infraspinatus reinnervation and function following spinal accessory nerve to suprascapular nerve transfer in adult traumatic brachial plexus injuries.Microsurgery 37:365-370.
Bertelli JA,Ghizoni MF(2016)Results of spinal accessory to suprascapular nerve transfer in 110 patients with complete palsy of the brachial plexus.J Neurosurg Spine 24:990-995.
Bhatia A,P Doshi,A Koul,V Shah,JM Brown,M Salama(2017)Contralateral C-7 transfer:is direct repair really superior to grafting?Neurosurg Focus 43:E3.
Boyd KU,Nimigan AS,Mackinnon SE(2011)Nerve reconstruction in the hand and upper extremity.Clin Plast Surg 38:643-660.
Chin B,Ramji M,Farrokhyar F,Bain JR(2018)Efficient imaging:examining the value of ultrasound in the diagnosis of traumatic adult brachial plexus injuries:a systematic review.Neurosurgery 83:323-332.
Cho MS,Rinker BD,Weber RV,Chao JD,Ingari JV,Brooks D,Buncke GM(2012)Functional outcome following nerve repair in the upper extremity using processed nerve allograft.J Hand Surg Am 37:2340-2349.
Chuang DC,Cheng SL,Wei FC,Wu CL,Ho YS(1998):Clinical evaluation of C7 spinal nerve transection:21 patients with at least 2 years’follow-up.Br J Plast Surg 51:285-290.
Chung S(2019)Body composition analysis and references in children:clinical usefulness and limitations.Eur J Clin Nutr 73:236-242.
Davis EN,Chung KC(2004)The tinel sign:a historical perspective.Plast Reconstr Surg 114:494-499.
Deal DN,Griffin JW,Hogan MV(2012)Nerve conduits for nerve repair or reconstruction.J Am Acad Orthop Sur 20:63-68.
Galloway KM,Gautam AJ,Hogan E,Rice E,Woodard C(2018)Gender,side to side and BMI differences in long thoracic nerve conduction velocity:a novel technique.Clin Neurophysiol Pract 3:45-48.
Gao KM,Lao J,Guan WJ,Hu J(2018a)Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?Neural Regen Res 13:94-99.
Gao KM,Hu JJ,Lao J,Zhao X(2018b)Evaluation of nerve transfer options for treating total brachial plexus avulsion injury:a retrospective study of 73 participants.Neural Regen Res 13:470-476.
Gu Y,Xu J,Chen L,Wang H,Hu S(2002)Long term outcome of contralateral C7 transfer:a report of 32 cases.Chin Med J(Engl)115:866-868.
Gu YD,GM Zhang,DS Chen,JG Yan,XM Cheng,L Chen(1992)Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion.J Hand Surg Br17:518-521.
He B,Q Zhu,Y Chai,X Ding,J Tang,L Gu,J Xiang,Y Yang,J Zhu,XLiu(2015)Safety and efficacy evaluation of a human acellular nerve graft as a digital nerve scaffold:a prospective,multicentre controlled clinical trial.J Tissue Eng Regen Med 9:286-295.
Hoffmann P,Buck-Gramcko D,Lubahn JD(1993)The Hoffmann-Tinel sign.1915.J Hand Surg Br 18:800-805.
Hole K,Heiberg PL,Gjestad C,Mehus LL(2018)Elevated 4β-hydroxycholesterol/cholesterol ratio in anorexia nervosa patients.Perspectives 6:e00430.
Hou Y,Yang J,Yang Y,Qin B,Fu G,Li X,Gu L,Liu X,Zhu Q,Qi J(2015)Flow-through anastomosis using a T-shaped vascular pedicle for gracilis functioning free muscle transplantation in brachial plexus injury.Clinics 70:544-549.
Hu J,Zhu Q,Liu X,Xu Y,Zhu J(2007)Repair of extended peripheral nerve lesions in rhesus monkeys using acellular allogenic nerve grafts implanted with autologous mesenchymal stem cells.Exp Neurol 204:658-666.
Huan KWSJ,Tan JSW,Tan SH,Teoh LC,Yong FC(2017)Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve:a report of 13 cases.JHand Surg Eur Vol 42:700-705.
Jiang S,Ichihara S,Prunières G,Peterson B,Facca S,Xu W,Liverneaux P(2016)Robot-assisted C7 nerve root transfer from the contralateral healthy side:a preliminary cadaver study.Hand Surg Rehabil 35:95-99.
Jiang Y,Wang L,Lao J,Zhao X(2018)Total brachial plexus injury:contralateral C7 root transfer to the lower trunk versus the median nerve.Neural Regen Res 13:1968.
Kovachevich R,Kircher MF,Wood CM,Spinner RJ,Bishop AT,Shin AY(2010)Complications of intercostal nerve transfer for brachial plexus reconstruction.J Hand Surg 35:1995-2000.
Leblebicioglu G,Ayhan C,Firat T,Uzumcugil A,Yorubulut M,Doral MN(2016)Recovery of upper extremity function following endoscopically assisted contralateral C7 transfer for obstetrical brachial plexus injury.J Hand Surg Eur Vol 41:863-874.
Lee CH,Dellon AL(2004)Prognostic ability of tinel sign in determining outcome for decompression surgery in diabetic and nondiabetic neuropathy.Ann Plas Surg 53:523-527.
Li F,Wang S,Li P,Xue Y,Zou J,Li W(2018)Restoration of active pickup function in patients with total brachial plexus avulsion injuries.JHand Surg Eur Vol 43:269-274.
Li L,Yang J,Qin B,Wang H,Yang Y,Fang J,Chen G,Liu X,Tu Z,Gu L(2019)Analysis of human acellular nerve allograft combined with contralateral C7 nerve root transfer for restoration of shoulder abduction and elbow flexion in brachial plexus injury:a mean 4-year follow-up.J Neurosurg doi:10.3171/2019.2.JNS182620.
Li X,Yang J,Hou Y,Yang Y,Qin B,Fu G,Gu L(2016):Donor-side morbidity after contralateral C7 nerve transfer:results at a minimum of 6months after surgery.J Neurosurg 124:1434-1441.
Mackinnon SE,Doolabh VB,Novak CB,Trulock EP(2001)Clinical outcome following nerve allograft transplantation.Plast Reconstr Surg 107:1419-1429.
Mcguiness CN,Kay SP(2002)The prespinal route in contralateral C7nerve root transfer for brachial plexus avulsion injuries.J Hand Surg27:159-160.
Meek MF,Coert JH(2008)US Food and Drug Administration/Conformit Europe-approved absorbable nerve conduits for clinical repair of peripheral and cranial nerves.Ann Plas Surg 60:110-116.
Moore AM,Ray WZ,Chenard KE,Tung T,Mackinnon SE(2009)Nerve allotransplantation as it pertains to composite tissue transplantation.Hand 4:239-244.
Qin B,Fu G,Yang J,Wang H,Zhu Q,Liu X,Zhu J,Gu L(2016)Microanatomy of the separable length of the C7.J Reconstr Microsurg32:109-113.
Ray WZ,Mackinnon SE(2010)Management of nerve gaps:Autografts,allografts,nerve transfers,and end-to-side neurorrhaphy.Exp Neurol223:77-85.
Ray WZ,Chang J,Hawasli A,Wilson TJ,Yang L(2016)Motor nerve transfers:a comprehensive review.Neurosurgery 78:1-26.
Socolovsky M,di Masi G,Bonilla G,Lovaglio AC,Lopez D(2017)Age as a predictor of long-term results in patients with brachial plexus palsies undergoing surgical repair.Oper Neurosurg(Hagerstown)15:15-24.
Socolovsky M,Malessy M,Bonilla G,Di Masi G,Conti ME,Lovaglio A(2018)Phrenic to musculocutaneous nerve transfer for traumatic brachial plexus injuries:analyzing respiratory effects on elbow flexion control.J Neurosurg doi:10.3171/2018.4.JNS173248.
Song H,Zhai X,Gao Z,Lu T,Tian Q,Li H,He X(2018)Reliability and validity of a Coda Motion 3-D Analysis system for measuring cervical range of motion in healthy subjects.J Electromyogr Kines 38:56-66.
Terzis JK,A Barmpitsioti(2010)Axillary nerve reconstruction in 176posttraumatic plexopathy patients.Plast Reconstr Surg 125:233-247.
Vanaclocha V,Herrera JM,Verdu-Lopez F,Gozalbes,L Sanchez-Pardo M,Rivera M,Martinez-Gomez D,Mayorga JD(2015)Transdiscal C6-C7 contralateral C7 nerve root transfer in the surgical repair of brachial plexus avulsion injuries.Acta Neurochir 157:2161-2167.
Wang D,Liu X,Zhu J,Jiang L,Hu J,Zhang Y,Yang L,Wang H,Yi J(2008)Bridging small-gap peripheral nerve defects using acellular nerve allograft implanted with autologous bone marrow stromal cells in primates.Brain Res 1188:44-53.
Wang G,Yu A,Ng CY,Lei G,Wang X,Qiu Y,Feng J,Li T,Chen Q,He Q,Ding F,Cui S,Gu Y,Xu J,Jiang S,Xu W(2018)Contralateral C7to C7 nerve root transfer in reconstruction for treatment of total brachial plexus palsy:anatomical basis and preliminary clinical results.JNeurosurg Spine 29:491-499.
Wang S,Yiu H,Li P,Li Y,Wang H,Pan Y(2012)Contralateral C7 nerve root transfer to neurotize the upper trunk via a modified prespinal route in repair of brachial plexus avulsion injury.Microsurg 32:183-188.
Wang S,Li P,Xue Y,Yiu H,Li Y,Wang H(2013)Contralateral C7 nerve transfer with direct coaptation to restore lower trunk function after traumatic brachial plexus avulsion.J Bone Joint Surg Am 95:821-827.
Xu L,Gu Y,Xu J,Lin S,Chen L,Lu J(2008)Contralateral C7 transfer via the prespinal and retropharyngeal route to repair brachial plexus root avulsion:a preliminary report.Neurosurgery 63:553-559.
Yang G,Chang KWC,Chung KC(2015)A systematic review of outcomes of contralateral c7 transfer for the treatment of traumatic brachial plexus injury.Plast Reconstr Surg 136:480e-489e.
Yu A,Wang S,Cheng X,Liang W,Bai R,Xue Y,Li W(2017)Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer:a resting-state fMRI study.Neuroradiology 59:247-253.
Zheng MX,Hua XY,Feng JT,Li T,Lu YC,Shen YD,Cao XH,Zhao NQ,Lyu JY,Xu JG,Gu YD,Xu WD(2018)Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis.N Engl J Med378:22-34.
Zhu S,J Liu,C Zheng,L Gu,Q Zhu,J Xiang,B He,X Zhou,X Liu(2017)Analysis of human acellular nerve allograft reconstruction of 64injured nerves in the hand and upper extremity:a 3 year follow-up study.J Tissue Eng Regen Med 11:2314-2322.
Zhu Z,Zhou X,He B,Dai T,Zheng C,Yang C,Zhu S,Zhu J,Zhu Q,Liu X(2015)Ginkgo biloba extract(egb 761)promotes peripheral nerve regeneration and neovascularization after acellular nerve allografts in a rat model.Cell Mol Neurobiol 35:273-282.
Bertelli JA,Ghizoni MF(2016)Results of spinal accessory to suprascapular nerve transfer in 110 patients with complete palsy of the brachial plexus.J Neurosurg Spine 24:990-995.
Bhatia A,P Doshi,A Koul,V Shah,JM Brown,M Salama(2017)Contralateral C-7 transfer:is direct repair really superior to grafting?Neurosurg Focus 43:E3.
Boyd KU,Nimigan AS,Mackinnon SE(2011)Nerve reconstruction in the hand and upper extremity.Clin Plast Surg 38:643-660.
Chin B,Ramji M,Farrokhyar F,Bain JR(2018)Efficient imaging:examining the value of ultrasound in the diagnosis of traumatic adult brachial plexus injuries:a systematic review.Neurosurgery 83:323-332.
Cho MS,Rinker BD,Weber RV,Chao JD,Ingari JV,Brooks D,Buncke GM(2012)Functional outcome following nerve repair in the upper extremity using processed nerve allograft.J Hand Surg Am 37:2340-2349.
Chuang DC,Cheng SL,Wei FC,Wu CL,Ho YS(1998):Clinical evaluation of C7 spinal nerve transection:21 patients with at least 2 years’follow-up.Br J Plast Surg 51:285-290.
Chung S(2019)Body composition analysis and references in children:clinical usefulness and limitations.Eur J Clin Nutr 73:236-242.
Davis EN,Chung KC(2004)The tinel sign:a historical perspective.Plast Reconstr Surg 114:494-499.
Deal DN,Griffin JW,Hogan MV(2012)Nerve conduits for nerve repair or reconstruction.J Am Acad Orthop Sur 20:63-68.
Galloway KM,Gautam AJ,Hogan E,Rice E,Woodard C(2018)Gender,side to side and BMI differences in long thoracic nerve conduction velocity:a novel technique.Clin Neurophysiol Pract 3:45-48.
Gao KM,Lao J,Guan WJ,Hu J(2018a)Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?Neural Regen Res 13:94-99.
Gao KM,Hu JJ,Lao J,Zhao X(2018b)Evaluation of nerve transfer options for treating total brachial plexus avulsion injury:a retrospective study of 73 participants.Neural Regen Res 13:470-476.
Gu Y,Xu J,Chen L,Wang H,Hu S(2002)Long term outcome of contralateral C7 transfer:a report of 32 cases.Chin Med J(Engl)115:866-868.
Gu YD,GM Zhang,DS Chen,JG Yan,XM Cheng,L Chen(1992)Seventh cervical nerve root transfer from the contralateral healthy side for treatment of brachial plexus root avulsion.J Hand Surg Br17:518-521.
He B,Q Zhu,Y Chai,X Ding,J Tang,L Gu,J Xiang,Y Yang,J Zhu,XLiu(2015)Safety and efficacy evaluation of a human acellular nerve graft as a digital nerve scaffold:a prospective,multicentre controlled clinical trial.J Tissue Eng Regen Med 9:286-295.
Hoffmann P,Buck-Gramcko D,Lubahn JD(1993)The Hoffmann-Tinel sign.1915.J Hand Surg Br 18:800-805.
Hole K,Heiberg PL,Gjestad C,Mehus LL(2018)Elevated 4β-hydroxycholesterol/cholesterol ratio in anorexia nervosa patients.Perspectives 6:e00430.
Hou Y,Yang J,Yang Y,Qin B,Fu G,Li X,Gu L,Liu X,Zhu Q,Qi J(2015)Flow-through anastomosis using a T-shaped vascular pedicle for gracilis functioning free muscle transplantation in brachial plexus injury.Clinics 70:544-549.
Hu J,Zhu Q,Liu X,Xu Y,Zhu J(2007)Repair of extended peripheral nerve lesions in rhesus monkeys using acellular allogenic nerve grafts implanted with autologous mesenchymal stem cells.Exp Neurol 204:658-666.
Huan KWSJ,Tan JSW,Tan SH,Teoh LC,Yong FC(2017)Restoration of shoulder abduction in brachial plexus avulsion injuries with double neurotization from the spinal accessory nerve:a report of 13 cases.JHand Surg Eur Vol 42:700-705.
Jiang S,Ichihara S,Prunières G,Peterson B,Facca S,Xu W,Liverneaux P(2016)Robot-assisted C7 nerve root transfer from the contralateral healthy side:a preliminary cadaver study.Hand Surg Rehabil 35:95-99.
Jiang Y,Wang L,Lao J,Zhao X(2018)Total brachial plexus injury:contralateral C7 root transfer to the lower trunk versus the median nerve.Neural Regen Res 13:1968.
Kovachevich R,Kircher MF,Wood CM,Spinner RJ,Bishop AT,Shin AY(2010)Complications of intercostal nerve transfer for brachial plexus reconstruction.J Hand Surg 35:1995-2000.
Leblebicioglu G,Ayhan C,Firat T,Uzumcugil A,Yorubulut M,Doral MN(2016)Recovery of upper extremity function following endoscopically assisted contralateral C7 transfer for obstetrical brachial plexus injury.J Hand Surg Eur Vol 41:863-874.
Lee CH,Dellon AL(2004)Prognostic ability of tinel sign in determining outcome for decompression surgery in diabetic and nondiabetic neuropathy.Ann Plas Surg 53:523-527.
Li F,Wang S,Li P,Xue Y,Zou J,Li W(2018)Restoration of active pickup function in patients with total brachial plexus avulsion injuries.JHand Surg Eur Vol 43:269-274.
Li L,Yang J,Qin B,Wang H,Yang Y,Fang J,Chen G,Liu X,Tu Z,Gu L(2019)Analysis of human acellular nerve allograft combined with contralateral C7 nerve root transfer for restoration of shoulder abduction and elbow flexion in brachial plexus injury:a mean 4-year follow-up.J Neurosurg doi:10.3171/2019.2.JNS182620.
Li X,Yang J,Hou Y,Yang Y,Qin B,Fu G,Gu L(2016):Donor-side morbidity after contralateral C7 nerve transfer:results at a minimum of 6months after surgery.J Neurosurg 124:1434-1441.
Mackinnon SE,Doolabh VB,Novak CB,Trulock EP(2001)Clinical outcome following nerve allograft transplantation.Plast Reconstr Surg 107:1419-1429.
Mcguiness CN,Kay SP(2002)The prespinal route in contralateral C7nerve root transfer for brachial plexus avulsion injuries.J Hand Surg27:159-160.
Meek MF,Coert JH(2008)US Food and Drug Administration/Conformit Europe-approved absorbable nerve conduits for clinical repair of peripheral and cranial nerves.Ann Plas Surg 60:110-116.
Moore AM,Ray WZ,Chenard KE,Tung T,Mackinnon SE(2009)Nerve allotransplantation as it pertains to composite tissue transplantation.Hand 4:239-244.
Qin B,Fu G,Yang J,Wang H,Zhu Q,Liu X,Zhu J,Gu L(2016)Microanatomy of the separable length of the C7.J Reconstr Microsurg32:109-113.
Ray WZ,Mackinnon SE(2010)Management of nerve gaps:Autografts,allografts,nerve transfers,and end-to-side neurorrhaphy.Exp Neurol223:77-85.
Ray WZ,Chang J,Hawasli A,Wilson TJ,Yang L(2016)Motor nerve transfers:a comprehensive review.Neurosurgery 78:1-26.
Socolovsky M,di Masi G,Bonilla G,Lovaglio AC,Lopez D(2017)Age as a predictor of long-term results in patients with brachial plexus palsies undergoing surgical repair.Oper Neurosurg(Hagerstown)15:15-24.
Socolovsky M,Malessy M,Bonilla G,Di Masi G,Conti ME,Lovaglio A(2018)Phrenic to musculocutaneous nerve transfer for traumatic brachial plexus injuries:analyzing respiratory effects on elbow flexion control.J Neurosurg doi:10.3171/2018.4.JNS173248.
Song H,Zhai X,Gao Z,Lu T,Tian Q,Li H,He X(2018)Reliability and validity of a Coda Motion 3-D Analysis system for measuring cervical range of motion in healthy subjects.J Electromyogr Kines 38:56-66.
Terzis JK,A Barmpitsioti(2010)Axillary nerve reconstruction in 176posttraumatic plexopathy patients.Plast Reconstr Surg 125:233-247.
Vanaclocha V,Herrera JM,Verdu-Lopez F,Gozalbes,L Sanchez-Pardo M,Rivera M,Martinez-Gomez D,Mayorga JD(2015)Transdiscal C6-C7 contralateral C7 nerve root transfer in the surgical repair of brachial plexus avulsion injuries.Acta Neurochir 157:2161-2167.
Wang D,Liu X,Zhu J,Jiang L,Hu J,Zhang Y,Yang L,Wang H,Yi J(2008)Bridging small-gap peripheral nerve defects using acellular nerve allograft implanted with autologous bone marrow stromal cells in primates.Brain Res 1188:44-53.
Wang G,Yu A,Ng CY,Lei G,Wang X,Qiu Y,Feng J,Li T,Chen Q,He Q,Ding F,Cui S,Gu Y,Xu J,Jiang S,Xu W(2018)Contralateral C7to C7 nerve root transfer in reconstruction for treatment of total brachial plexus palsy:anatomical basis and preliminary clinical results.JNeurosurg Spine 29:491-499.
Wang S,Yiu H,Li P,Li Y,Wang H,Pan Y(2012)Contralateral C7 nerve root transfer to neurotize the upper trunk via a modified prespinal route in repair of brachial plexus avulsion injury.Microsurg 32:183-188.
Wang S,Li P,Xue Y,Yiu H,Li Y,Wang H(2013)Contralateral C7 nerve transfer with direct coaptation to restore lower trunk function after traumatic brachial plexus avulsion.J Bone Joint Surg Am 95:821-827.
Xu L,Gu Y,Xu J,Lin S,Chen L,Lu J(2008)Contralateral C7 transfer via the prespinal and retropharyngeal route to repair brachial plexus root avulsion:a preliminary report.Neurosurgery 63:553-559.
Yang G,Chang KWC,Chung KC(2015)A systematic review of outcomes of contralateral c7 transfer for the treatment of traumatic brachial plexus injury.Plast Reconstr Surg 136:480e-489e.
Yu A,Wang S,Cheng X,Liang W,Bai R,Xue Y,Li W(2017)Functional connectivity of motor cortical network in patients with brachial plexus avulsion injury after contralateral cervical nerve transfer:a resting-state fMRI study.Neuroradiology 59:247-253.
Zheng MX,Hua XY,Feng JT,Li T,Lu YC,Shen YD,Cao XH,Zhao NQ,Lyu JY,Xu JG,Gu YD,Xu WD(2018)Trial of contralateral seventh cervical nerve transfer for spastic arm paralysis.N Engl J Med378:22-34.
Zhu S,J Liu,C Zheng,L Gu,Q Zhu,J Xiang,B He,X Zhou,X Liu(2017)Analysis of human acellular nerve allograft reconstruction of 64injured nerves in the hand and upper extremity:a 3 year follow-up study.J Tissue Eng Regen Med 11:2314-2322.
Zhu Z,Zhou X,He B,Dai T,Zheng C,Yang C,Zhu S,Zhu J,Zhu Q,Liu X(2015)Ginkgo biloba extract(egb 761)promotes peripheral nerve regeneration and neovascularization after acellular nerve allografts in a rat model.Cell Mol Neurobiol 35:273-282.