Surgical Treatment of Brachial Plexus Injury

Spustit vědomostní test Česká verze

Authors: P. Haninec; R. Kaiser
Authors place of work: Neurochirurgická klinika 3. LF UK a FN Královské Vinohrady, Praha
Published in the journal: Cesk Slov Neurol N 2011; 74/107(6): 619-630
Category: Minimonografie

Summary

Brachial plexus injury has been attracting increasing attention in recent times, partly because of an increasing incidence arising out of higher survival rates for patients after polytrauma and also due to higher success rates for surgical treatment. Obstetric brachial plexus palsy has recently become the focus of interest for a number of articles. Many injured elements of the brachial plexus are reconstructed by a donor nerve transferred onto the recipient nerve, i.e. by neurotization. This method leads to better outcomes than suture of the injured nerve in the proximal part of the plexus, the main advantage of which is the opportunity to place the suture as close to the muscle as possible. There are two newer methods – Oberlin´s technique and end-to-side anastomosis. It remains unclear as to which donor nerve is better to use for neurotization in specific recipients due to a lack of large, randomized clinical trials. Generally, neurotization using the intraplexal nerve as a donor of motor nerve fibres is more successful than neurotization using the extraplexal nerve.

Key words:
brachial plexus injury – neurotization – Oberlin´s technique – end-to-side anastomosis – nerve suture – obstetric brachial plexus palsy

Zdroje

1. Songcharoen P. Brachial plexus injury in Thailand: a report of 520 cases. Microsurgery 1995; 16(1): 35–39.

2. Kim DH, Cho YJ, Tiel RL, Kline DG. Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg 2003; 98(5): 1005–1016.

3. Haninec P, Sámal F, Tomás R, Houstava L, Dubový P. Direct repair (nerve grafting), neurotization, and end--to-side neurorrhaphy in the treatment of brachial plexus injury. J Neurosurg 2007; 106(3): 391–399.

4. Vekris MD, Beris AE, Johnson EO, Korobilias AV, Pafilas D, Vekris AD et al. Musculocutaneous neurotization to restore elbow flexion in brachial plexus paralysis. Microsurgery 2006; 26(4): 325–329.

5. Lanaras TI, Schaller HE, Sinis N. Brachial plexus lesions: 10 years of experience in a center for microsurgery in Germany. Microsurgery 2009; 29(2): 87–94.

6. Jiang S, Li ZY, Hua XY, Xu WD, Xu JG, Gu YD. Reorganization in motor cortex after brachial plexus avulsion injury and repair with the contralateral C7 root transfer in rats. Microsurgery 2010; 30(4): 314–320.

7. Ahmed-Labib M, Golan JD, Jacques L. Functional outcome of brachial plexus reconstruction after trauma. Neurosurgery 2007; 61(5): 1016–1022.

8. Krishnan KG, Martin KD, Schackert G. Traumatic lesions of the brachial plexus: an analysis of outcomes in primary brachial plexus reconstruction and secondary functional arm reanimation. Neurosurgery 2008; 62(4): 873–885.

9. Bertelli JA, Ghizoni MF, Loure Iro Chaves DP. Sensory disturbances and pain complaints after brachial plexus root injury: A prospective study involving 150 adult patients. Microsurgery 2011; 31(2): 93–97.

10. Millesi H. Surgical management of brachial plexus injuries. J Hand Surg (Am) 1977; 2(5): 367–378.

11. Narakas A. Surgical treatment of traction injuries of the brachial plexus. Clin Orthop 1978; 133: 71–90.

12. Kandenwein JA, Kretschmer T, Engelhardt M, Richter HP, Antoniadis G. Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases. J Neurosurg 2005; 103(4): 614–621.

13. Bertelli JA, Ghizoni MF. Concepts of nerve regeneration and repair applied to brachial plexus reconstruction. Microsurgery 2006 a; 26(4): 230–244.

14. Kline DG, Judice DJ. Operative management of selected brachial plexus lesions. J Neurosurg 1983; 58(5): 631–649.

15. Narakas A. Obstetrical brachial plexus injuries. In: Lamb D (ed). The Paralyzed Hand. Edinburgh: Churchill Livingstone 1987: 116–135.

16. Maillet M, Romana C. Complete obstetric brachial plexus palsy: surgical improvement to recover a functional hand. J Child Orthop 2009; 3(2): 101–118.

17. Samii M, Carvalho GA, Nikkhah G, Penkert G. Surgical reconstruction of the musculocutaneous nerve in traumatic brachial plexus injuries. J Neurosurg 1997; 87(6): 881–886.

18. Oberlin C, Beal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5–C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am 1994; 19(2): 232–237.

19. Songcharoen P. Management of brachial plexus injury in adults. Scand J Surg 2008; 97(4): 317–323.

20. Gilbert A, Pivato G, Kheiralla T. Long-term results of primary repair of brachial plexus lesions in children. Microsurgery 2006; 26(4): 334–342.

21. Sunderland S. Nerves and nerve injuries. Edinburgh: Churchill Livingstone 1972.

22. Pondaag W, de Boer R, van Wijlen-Hempel MS, Hofstede-Buitenhuis SM, Malessy MJ. External rotation as a result of suprascapular nerve neurotization in obstetric brachial plexus lesions. Neurosurgery 2005; 57(3): 530–537.

23. Russell SM, Kline DG. Complication avoidance in peripheral nerve surgery: preoperative evaluation of nerve injuries and brachial plexus exploration – part 1. Neurosurgery 2006; 59 (4 Suppl 2): ONS441–ONS447.

24. Chen L, Gu YD, Wang H. Microsurgical reconstruction of obstetric brachial plexus palsy. Microsurgery 2008; 28(2): 108–112.

25. Tomáš R, Stejskal L, Haninec P, Houšťava L. Intraoperative monitoring and dorsal column pathway determination in DREZ thermocoagulation. Bolest 2001; 4(1): 34–38.

26. Macko J. Perinatální paréza brachiálního plexu. Cesk Gynekol 2010; 75(4): 279–283.

27. Janda V. Funkční svalový test. Praha: Grada, Avicenum 1996.

28. Haninec P, Houšťava L, Tomáš R, Stejskal L. DREZ thermocoagulation. Bolest 2001; 4(1): 28–32.

29. Haninec P, Tomáš R, Sereghy T, Houšťava L. DREZ thermocoagulation in treatment of deafferentation pain. Bolest 2002; 5(3): 177–180.

30. Tomás R, Haninec P. Dorsal root entry zone (DREZ) localization using direct spinal cord stimulation can improve results of the DREZ termocoagulation procedure for intractable pain relief. Pain 2005; 116(1–2): 159–163.

31. Bonilla G, Di Masi G, Battaglia D, Otero JM, Socolovsky M. Pain and brachial plexus lesions: evaluation of initial outcomes after reconstructive microsurgery and validation of a new pain severity scale. Acta Neurochir (Wien) 2011; 153(1): 171–176.

32. Bertelli JA, Ghizoni MF. Use of clinical signs and computed tomography myelography findings in detecting and excluding nerve root avulsion in complete brachial plexus palsy. J Neurosurg 2006; 105(6): 835–842.

33. Kaiser R, Houšťava L, Mencl L, Brzezny R, Haninec P. Operační léčba poranění peroneálního nervu. Cesk Slov Neurol N 2011; 74/107(2): 187–190.

34. Belzberg AJ, Dorsi MJ, Storm PB, Moriarity JL. Surgical repair of brachial plexus injury: a multinational survey of experienced peripheral nerve surgeons. J Neurosurg 2004; 101(3): 365–376.

35. Brown JM, Shah MN, Mackinnon SE. Distal nerve transfers: a biology-based rationale. Neurosurg Focus 2009; 26(2): E12.

36. Midha R. Nerve transfers for severe brachial plexus injuries: a review. Neurosurg Focus 2004; 16(5): E5.

37. Stejskal L, Haninec P. Indications for surgical reconstruction of the brachial plexus. electrodiagnostic. results of reconstructions. Cesk Slov Neurol N 1997; 60/93(3): 126–133.

38. Marcus JR, Clarke HM. Management of obstetrical brachial plexus palsy evaluation, prognosis, and primary surgical treatment. Clin Plast Surg 2003; 30(2): 289–306.

39. Birch R, Ahad N, Kono H, Smith S. Repair of obstetric brachial plexus palsy – Results in 100 children. J Bone Joint Surg (Br) 2005; 87(8): 1089–1095.

40. Bain JR, Dematteo C, Gjertsen D, Hollenberg RD. Navigating the gray zone: a guideline for surgical decision making in obstetrical brachial plexus injuries. J Neurosurg Pediatr 2009; 3(3): 173–180.

41. Chuang DC, Mardini S, Ma HS. Surgical strategy for infant obstetrical brachial plexus palsy: Experiences at Chang Gung Memorial Hospital. Plast Reconstr Surg 2005; 116(1): 132–142.

42. Haninec P, Kaiser R, Brzezny R, Mencl L. Chirurgická léčba porodní parézy brachiálního plexu. Neonatol Listy 2011; 17(1): 3–8.

43. Pondaag W, Malessy MJ. Recovery of hand function following nerve grafting and transfer in obstetric brachial plexus lesions. J Neurosurg 2006; 105 (1 Suppl): 33–40.

44. Tender GC, Kline DG. Anterior supraclavicular approach to the brachial plexus. Neurosurgery 2006; 58 (4 Suppl 2): ONS360–ONS364.

45. Malessy MJ, de Ruiter GC, de Boer KS, Thomeer RT. Evaluation of suprascapular nerve neurotization after nerve graft or transfer in the treatment of brachial plexus traction lesions. J Neurosurg 2004; 101(3): 377–389.

46. Nath RK, Lyons AB, Bietz G. Physiological and clinical advantages of median nerve fascicle transfer to the musculocutaneous nerve following brachial plexus root avulsion injury. J Neurosurg 2006; 105(6): 830–834.

47. Harris W, Low VW. On the importance of accurate muscular analysis in lesions of the brachial plexus and the treatment of Erb’s palsy and infantile paralysis of the upper extremity by cross-union of nerve roots. BMJ 1903; 2: 1035–1038.

48. Tuttle HK. Exposure of the brachial plexus with nerve transplantation. JAMA 1913; 61: 15–17.

49. MacKinnon SE, Roque B, Tung TH. Median to radial nerve transfer for treatment of radial nerve palsy. Case report. J Neurosurg 2007; 107(3): 666–671.

50. Ferraresi S, Garozzo D, Buffatti P. Reinnervation of the biceps in C5–7 brachial plexus avulsion injuries: results after distal bypass surgery. Neurosurg Focus 2004; 16(5): E6.

51. Terzis JK, Kostas I, Soucacos PN. Restoration of shoulder function with nerve transfers in traumatic brachial plexus palsy patients. Microsurgery 2006; 26(4): 316–324.

52. Sulaiman OA, Kim DD, Burkett C, Kline DG. Nerve transfer surgery for adult brachial plexus injury: a 10--year experience at Louisiana State University. Neurosurgery 2009; 65 (4 Suppl): A55–A62.

53. Samardzic MM, Grujicic DM, Rasulic LG, Milicic BR. The use of thoracodorsal nerve in restoration of irreparable C5 and C6 spinal nerve lesions. Br J Plast Surg 2005; 58(4): 541–546.

54. Luedemann W, Hamm M, Blömer U, Samii M, Tatagiba M. Brachial plexus neurotization with donor phrenic nerves and its effect on pulmonary function. J Neurosurg 2002; 96(3): 523–526.

55. Malessy MJA, Hoffman CFE, Thomeer RTWM. Initial report on the limited value of hypoglossal nerve transfer to treat brachial plexus avulsions. J Neurosurg 1999; 91: 601–604.

56. Songcharoen P, Mahaisavariya B, Wongtrakul S, Lamsam C. Ipsilateral median nerve´s fascicle transfer for restoration of elbow flexion in root avulsion brachial plexus injury. J Thai Orthop Surg 2001; 26(2): 93–95.

57. Sungpet A, Suphachatwong C, Kawinwonggowit V. One-fascicle median nerve transfer to biceps muscle in C5 and C6 root avulsions of brachial plexus injury. Microsurgery 2003; 23(1): 10–13.

58. Kennedy R. On the resoration of co-ordinated movements after nerve crossing, with interchange of fiction of the cerebral cortical centres. Philos Trans R Soc London 1901; 194B: 127–164.

59. Viterbo F, Trinidade JC, HoshinoK, Mazzoni A. Latero-terminal neurorrhaphy without removal of the epineural sheath: experimantal study in rats. Sao Paulo Med J 1992; 110(6): 267–275.

60. Geuna S, Papalia I, Tos P. End-to-side (terminolateral) nerve regeneration: a challenge for neuroscientists coming from an intriguing nerve repair concept. Brain Res Rev 2006; 52(2): 381–388.

61. Schmidhammer R, Nógrádi A, Szabó A, Redl H, Hausner T, van der Nest DG et al. Synergistic motor nerve fiber transfer between different nerves through the use of end-to-side coaptation. Exp Neurol 2009; 217(2): 388–394.

62. Oğün TC, Ozdemir M, Senaran H, Ustün ME. End-to-side neurorrhaphy as a salvage procedure for irreparable nerve injuries. Technical note. J Neurosurg 2003; 99(1): 180–185.

63. Beris A, Lykissas M, Korompilias A, Mitsionis G. End-to-side nerve repair in peripheral nerve injury. J Neurotrauma 2007; 24(5): 909–916.

64. Mennen U. End-to-side nerve suture in clinical practice. Hand Surg 2003; 8(1): 33–42.

65. Lutz BS, Chuang DC, Hsu JC, Ma SF, Wei FC. Selection of donor nerves – an important factor in end-to-side neurorrhaphy. Br J Plast Surg 2000; 53(2): 149–154.

66. Sámal F, Haninec P, Raska O, Dubový P. Quantitative assessment of the ability of collateral sprouting of the motor and primary sensory neurons after the end-to-side neurorrhaphy of the rat musculocutaneous nerve with the ulnar nerve. Ann Anat 2006; 188(4): 337–344.

67. Hayashi A, Pannucci C, Moradzadeh A, Kawamura D, Magill C, Hunter DA et al. Axotomy or compression is required for axonal sprouting following end-to-side neurorrhaphy. Exp Neurol 2008; 211(2): 539–550.

68. Kelly EJ, Jacoby C, Terenghi G, Mennen U, Ljungberg C, Wiberg M. End-to-side nerve coaptation: a qualitative and quantitative assessment in the primate. J Plast Reconstr Aesthet Surg 2007; 60(1): 1–12.

69. Rovak JM, Cederna PS, Kuzon VW jr. Terminolateral neurorrhaphy: a review of the literature. J Reconstr Microsurg 2001; 17(8): 615–624.

70. Haastert K, Joswig H, Jäschke K, Samii M, Grothe C. Nerve repair by end-to-side nerve coaptation: Histologic and morphometric evaluation of axonal origin in a rat sciatic nerve model. Neurosurgery 2010; 66(3): 567–576.

71. Kim JK, Chung MS, Baek GH. The origin of regenerating axons after end-to-side neurorrhaphy without donor nerve injury. J Plast Reconstr Aesthet Surg 2011; 64(2): 255–260.

72. Walker JC, Brenner MJ, Mackinnon SE, Winograd JM, Hunter DA. Effect of perineurial window size on nerve regeneration, blood-nerve barrier integrity, and functional recovery. J Neurotrauma 2004; 21(2): 217–227.

73. Carlstedt T, Anand P, Hallin R, Misra PV, Norén G, Seferlis T. Spinal nerve root repair and reimplantation of avulsed ventral roots into the spinal cord after brachial plexus injury. J Neurosurg 2000; 93 (2 Suppl): 237–247.

74. Amr SM, Essam AM, Abdel-Meguid AM, Kholeif AM, Moharram AN, El-Sadek RE. Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy. J Brachial Plex Peripher Nerve Inj 2009; 4: 8.

75. Doi K, Sakai K, Kuwata N et al. Double free-muscle transfer to restore prehension following complete brachial plexus avulsion. J Hand Surg Am 1995; 20(3): 408–414.

76. Barrie KA, Steinmann SP, Shin AY, Spinner RJ, Bishop AT. Gracilis free muscle transfer for restoration of function after complete brachial plexus avulsion. Neurosurg Focus 2004; 16(5): E8.

77. Haninec P, Dubový P, Sámal F. Reconstruction of elbow flexion, wrist and finger extension by transposition of pedicled latissimus dorsi muscle and flexor carpi ulnaris muscle. Acta Chir Plast 2001; 43(3): 80–85.

78. Haninec P, Szeder V. Reconstruction of elbow flexion by transposition of pedicled long head of triceps brachii muscle. Acta Chir Plast 1999; 41(3): 82–86.

79. Haninec P, Smrčka V. Reconstruction of paralysed biceps brachii muscle by transposition of pedicled latissimus dorsi muscle: Report of two cases. Acta Chir Plast 1998; 40(2): 41–44.

80. Haninec P, Dubový P, Houšťava L, Stejskal L. Reconstructive operations of brachial plexus injury and the experimental model of their management. 11th International Congress of Neurological Surgery. Amsterdam, The Netherlands. 1997.

81. Haninec P, Dubový P, Houšťava L, Stejskal L. Surgical management of brachial plexus injuries and the experimental reinnervation of the biceps brachii muscle by the spinal motor neurons through acellular nerve graft. Congress of the International Federation of Societies for Surgery of the Hand. Vancouver, Canada. 1998.

82. Moiyadi AV, Devi BI, Nair KP. Brachial plexus injuries: outcome following neurotization with intercostal nerve. J Neurosurg 2007; 107(2): 308–313.

83. Terzis JK, Kokkalis ZT. Selective contralateral c7 transfer in posttraumatic brachial plexus injuries: a report of 56 cases. Plast Reconstr Surg 2009; 123(3): 927–938.

84. El-Gammal TA, El-Sayed A, Kotb MM, Ragheb YF, Saleh WR, Elnakeeb RM et al. Total obstetric brachial plexus palsy: results and strategy of microsurgical reconstruction. Microsurgery 2010; 30(3): 169–178.

85. Zheng XY, Hou CL, Gu YD, Shi QL, Guan SB. Repair of brachial plexus lower trunk injury by transferring brachialis muscle branch of musculocutaneous nerve: anatomic feasibility and clinical trials. Chin Med J (Engl) 2008; 121(2): 99–104.