gms | German Medical Science

Objectives/Interrogation: Previously articles reported that entire harvested cC7 nerve root transfer could obtain significantly better recovery than partial harvested cC7 nerve root transfer. We suppose that the harvesting of the entire cC7 nerve root might be the key factor for the good result of cC7 nerve transfer procedure. In order to confirm it, we conducted the current clinical and experimental study which aimed to determine whether it is necessary to use the entire root but not partial cC7 root to be the donor in the treating total BPAI.

Methods: In clinical study, a retrospective review of 73 patients with total BPAI was conducted. In group 1, the cC7 nerve was used to transfer to median nerve only. Three ways were used to harvest cC7 root which were the entire cC7, the posterior division + the lateral part of the anterior division the anterior or the posterior division alone. In group 2, the cC7 nerve was used to transfer to two nerves simultaneously. The entire cC7 transfer to median nerve and biceps branch in 12 and transfer to median nerve and triceps branch in 10 patients.

In experimental study, 54 SD rats were separated into 3 groups. In Group A: The entire root of cC7 was transected and transferred to median nerve; Group B: Only posterior division of cC7 root was transected and transferred to median nerve; Group C: The entire root of cC7 was transected while only the posterior division was transferred to median nerve. The regeneration of recipient nerve was evaluated post-operatively.

Results and Conclusions: The clinical study showed that entire harvested cC7 nerve root transfer could obtain significantly better recovery than partial harvested cC7 nerve root transfer when repairing median nerve. while if the entire cC7 nerve root was harvested for the transfer to median nerve together with biceps branch simultaneously, in which situation the donor for median nerve was just equal to partial cC7 root transfer, both of the two recipient nerves could achieve good recovery.

In experimental study, the evaluation of median nerve and FDS showed no statistical difference in the regeneration of median nerve between group A and C but significantly better group B.

We concluded that for the same recipient nerve, harvesting of the entire contralateral C7 root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a donor when transferring contralateral C7 nerve.