21 April 2023: Articles
Double Fascicular Nerve Transfer Restored Nearly Normal Functional Movements in a Completely Paralyzed Upper Extremity Resulting from an ACDF Surgery: A Case Report and Review of Recent Literature
Unusual clinical course, Educational Purpose (only if useful for a systematic review or synthesis)
Rahul K. Nath A* , Chandra Somasundaram CDOI: 10.12659/AJCR.938650
Am J Case Rep 2023; 24:e938650
Table 1. Recent reports on nerve transfer to restore shoulder abduction in patients with traumatic brachial plexus injury.
| Study | Type of nerve transfer– surgical procedure | Pre-operative diagnosis | Postoperative outcomes |
|---|---|---|---|
| 1. Our patient | A 45-year-old woman with total loss of the LUE functional movements. 0° in shoulder abduction following ACDF surgery | Restored to 170° of shoulder abduction from 0°; the other LUE functions improved to near normal 17 months following the nerve transfer surgery | |
| 2. Maldonado et al 2022 []20 | Triceps motor branch was transferred to the anterior division of the axillary nerve for reconstruction of the shoulder abduction | Case-control study: Axillary nerve injury or brachial plexus injury | Patients achieved 52±69° of shoulder abduction (successful group) and 27±30° of shoulder abduction (failure group) |
| 3. Malungpaishrope et al 2022 []16 | Spinal accessory nerve (SAN) was transferred for the supraspinatus muscle combined with transfer of the sixth and seventh intercostal nerves for the serratus anterior muscle along with the third to fifth intercostal nerves to the triceps muscles | C5, C6, C7 root avulsion injury | Shoulder abduction and external rotation improved to 71° and −21°, respectively |
| 4. Chuieng-Yi Lu et al 2022 []19 | Compared the phrenic nerve (Ph) and the SAN as the donor nerves | Brachial plexus injury multiple root injuries | The maximum degrees of shoulder abduction achieved was 61.9±38.7° in patients with Ph nerve transfer and 51.1±37.3° in patients with SAN transfer |
| 5. Makel et al 2022 []14 | The radial and the intercostal nerves were compared as donor nerves | Results of 15 articles (meta-analysis) | The best outcome in shoulder abduction was with the radial nerve transfer, 106.3±39.01. The highest abduction angle was a mean of 134° from 2 of the 5 patients in the study by Uerpairojkit et al []. The shoulder abduction improved to 80.4±24.9 with the intercostal nerve15 |