The experimental study and preliminary clinical application of C_7 nerve transfer to restore the lower limb function of paraplegia
- VernacularTitle:C_7神经移位重建截瘫双下肢功能的实验研究及初步临床应用
- Author:
Shufeng WANG
;
Zhongshui ZHOU
;
Zhanhui LU
- Publication Type:Journal Article
- Keywords:
Paraplegia;
Spinal nerve;
Femoral nerve;
Radial nerve;
Nerve regeneration
- From:
Chinese Journal of Orthopaedics
2001;0(08):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective Based on investigating the results of brachial plexus nerve transfer to repair the femoral nerve in rats, C7 nerve root transfer to femoral nerve autograft to reconstruct the function of quadriceps femoris of paraplegia was designed and evaluated clinically. Methods 16 SD rats were randomized into 2 groups. Group A: the radial nerve of the left side was severed, and the proximal end of the radial nerve was transferred to the femoral nerve of the lower limb on the same side through the vascularized sciatic nerve bridging in one stage; Group B: the radial nerve anastomosed with the bridging nerve at first, then 3 months later the femoral nerve was sectioned, and the distal end of which anastomosed with the bridging nerve. Electrophysiology and histology including amplitude of compound action muscle potential, muscle wet weight, cross section areas were used to evaluate the effects at sixth month after operation. Furthermore, two patients with paraplegia were treated by the C7 nerve root transfer to reconstruct the function of quadriceps femoris. The C7 was sectioned at the distal of nerve root , and proximal end was used for motor nerve, the vascularized tibial nerve sectioned at the middle of the crus and dissected to the rump along the posterior of lower limb was reversed to the ipsilateral cervical incision through the tunnel and used for bridging nerve to anastomose with the proximal end of C7. When the nerve fiber regenerated into the hip through bridging nerve, the femoral nerve was sectioned and distal end anastomosed with bridging nerve. Results There was no significant difference between the two groups in the results of nerve regeneration and amplitude of compound action muscle potential, but group B was superior to the group A in muscle net weight and section area of muscle fiber. One case suffered paraplegia had already been repaired the double side femoral nerve by the method, after 41 months follow up, the muscle power of quadriceps was 4 grade on the right side and 3 grade on the left. The other was followed up for 24 months, the muscle power of quadriceps was 2 grade on both sides. Conclusion C7 nerve transfer to repair the femoral nerve through the vascularized tibial nerve bridging in two stages could reconstruct the movement and sensation function of lower limb of paraplegia.
