Comparison of Anterior vs. Dorsal Approach for Spinal Accessory to Suprascapular Nerve Transfer in Patients With a Brachial Plexus Injury and Its Outcome on Shoulder Function.
anterior approach
bilateral brachial plexus injury
dorsal approach
nerve transfer
shoulder function
spinal accessory nerve
suprascapular nerve
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
accepted:
04
07
2022
entrez:
8
8
2022
pubmed:
9
8
2022
medline:
9
8
2022
Statut:
epublish
Résumé
Background Brachial plexus injuries are frequently encountered in the domain of plastic surgery, mostly secondary to road traffic accidents, gunshot injuries, or falls from a height. Many modalities have been described in the management, depending on the level and duration of the injury. C5, C6 and C5, C6, C7 are two common patterns in which nerve repair and transfers are described. At our center, we practice spinal accessory to suprascapular nerve transfer in all patients with upper trunk brachial plexus injury. There are two described approaches for the spinal accessory nerve to suprascapular nerve transfer, i.e. anterior or dorsal. The rationale for doing the posterior approach is that this approach avoids damaging the suprascapular nerve at its entrance in the suprascapular notch under the suprascapular ligament during exploration due to traction. Materials and methods This is a retrospective study with a consecutive sampling of 23 patients presenting at Liaquat National Hospital, Karachi, with upper trunk brachial plexus injuries during the time period from January 2016 to December 2017, i.e. two years. We divided these 23 patients into two groups, one with the anterior approach and the other with a dorsal approach for spinal accessory to suprascapular nerve transfer for shoulder abduction. The mean duration of post-surgical follow-up was from 18 to 24 months and recovery and functional outcomes were assessed. Results Out of the 23 patients that were included, 10 patients were operated on with an anterior approach and 13 with a posterior approach. Fifty percent (50%) of patients operated with the anterior approach and 84% of patients with the posterior showed the best motor grade recovery of M4, respectively, with better performance in patients with the posterior approach as compared to the anterior approach. Conclusion We advocate taking a posterior approach for spinal accessory to suprascapular nerve transfer for shoulder abduction, as it has shown better results with reliable outcomes concerning shoulder abduction, angle of abduction, and range of motion.
Identifiants
pubmed: 35936186
doi: 10.7759/cureus.26543
pmc: PMC9346609
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e26543Informations de copyright
Copyright © 2022, Tahir et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Indian J Plast Surg. 2021 Apr;54(2):152-156
pubmed: 34239236
Indian J Plast Surg. 2014 May;47(2):191-8
pubmed: 25190913
J Hand Surg Am. 2013 Jan;38(1):168-72
pubmed: 23261196
Hand (N Y). 2006 Dec;1(2):71-7
pubmed: 18780028
Neurosurg Rev. 2020 Jun;43(3):951-956
pubmed: 30997618
J Hand Surg Am. 2019 Jul;44(7):578-587
pubmed: 30898464
J Brachial Plex Peripher Nerve Inj. 2008 May 27;3:15
pubmed: 18505571
J Bone Joint Surg Br. 1997 Jul;79(4):527-31
pubmed: 9250730
Microsurgery. 2017 Jul;37(5):365-370
pubmed: 27206345
Microsurgery. 2006;26(4):316-24
pubmed: 16649194
Acta Neurochir (Wien). 2014 Dec;156(12):2345-9
pubmed: 25326278
Hand Clin. 2016 May;32(2):153-64
pubmed: 27094888
J Neurosurg Spine. 2016 Jun;24(6):990-5
pubmed: 26871649
J Orthop Sci. 1998;3(1):71-80
pubmed: 9654558
Clin Orthop Relat Res. 1988 Dec;(237):67-74
pubmed: 3191642
J Neurosurg. 2018 May 1;:1-13
pubmed: 29999446
J Neurosurg. 2005 Oct;103(4):614-21
pubmed: 16266042
Clin Anat. 2007 Mar;20(2):140-3
pubmed: 16944529
J Hand Surg Am. 2011 Jul;36(7):1182-90
pubmed: 21530102
Neurosurgery. 2011 Feb;68(2):390-5; discussion 396
pubmed: 21135731
Indian J Plast Surg. 2009 Jul;42(2):150-60
pubmed: 20368849
J Hand Surg Am. 2004 Jan;29(1):131-9
pubmed: 14751116
Neurosurgery. 2012 Dec;71(6):1156-60; discussion 1161
pubmed: 23037815
Ann Indian Acad Neurol. 2013 Jan;16(1):26-33
pubmed: 23661959
Chin Med J (Engl). 2006 May 5;119(9):707-12
pubmed: 16701009
J Postgrad Med. 2014 Jul-Sep;60(3):241-2
pubmed: 25272396
World Neurosurg. 2019 Jun;126:e1251-e1256
pubmed: 30898759
Plast Reconstr Surg. 2000 Oct;106(5):1097-1122; quiz 1123-4
pubmed: 11039383
Acta Neurochir (Wien). 2014 May;156(5):1025-8
pubmed: 24318512
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1217-1223
pubmed: 32980882
Microsurgery. 2004;24(3):182-7
pubmed: 15160375