Artikel
Analysis of Large Cohort of Spastic Arm Paralysis Patients after Contralateral Seventh Cervical Nerve Transfer: A Retrospective Study
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Autoren
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Wendong Xu
- Department of Hand Surgery, Huashan Hospital, The National Clinical Research Center for Aging and Medicine, Dept of Hand and Upper Extremity Surgery, Jingan DC Hospital, Shanghai, China
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Yudong Gu
- Department of Hand Surgery, Huashan Hospital, The National Clinical Research Center for Aging and Medicine, Dept of Hand and Upper Extremity Surgery, Jingan DC Hospital, Shanghai, China
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: The application of contralateral C7 transfer in treating central hemiplegia has achieved favorable results in our previous report. The aim of this study was to introduce the authors' experience with contralateral C7 transfer in patients with spastic arm paralysis in a larger number and to analyze the functional outcomes after over 1-year follow-up.
Methods: From 2008 to 2018, a retrospective study of upper limb function in patients with spastic arm paralysis caused by central nervous system injury with a follow-up of more than one year post-operatively were carried out in the hand surgery department of our center. Evaluation methods include Fugl-Meyer upper-extremity scale, Modified Ashworth Scale and active range of motion, which were compared before and consecutively throughout 1-year after operation. Through subgroup analysis, the etiology or factors which might affect postoperative functional recovery and the spasm degree such as gender, age, and affected side were analyzed.
Results and Conclusions: Since 2008, over 200 spastic arm paralysis patients received contralateral C7 nerve transfer surgery in our center. In retrospective analysis, we found that there was a significant increase in the mean Fugl-Meyer score from the baseline to 1-year postoperatively. In the grouped analysis stratified by age, there was an obvious tendency that younger patients acquired higher scores. In the etiological analysis, cerebral palsy patients acquired the largest increase in total Fugl-Meyer score comparing to other groups. There was no significant difference in the functional recovery between paralysis side and gender. Spasticity from baseline to 1-year as measured on the Modified Ashworth Scale showed a decrease in all joints.
In conclusion, in a large cohort retrospective study, functional improvement in patients were noted with different etiology, age, gender and paralyzed side. Generally, cerebral palsy and younger patients were expected to have better functional improvement comparing to other subgroups.
