Abstract
Brachial plexus avulsion results from excessive stretching and can occur secondary to motor vehicle accidents, mainly in motorcyclists. In a 28-year-old man with panavulsive brachial plexus palsy, we describe an alternative technique to repair brachial plexus avulsion and to stabilize and preserve shoulder function by transferring the contralateral spinal accessory nerve to the suprascapular nerve. We observed positive clinical and electromyographic results in sternocleidomastoid, trapezius, supraspinatus, infraspinatus, pectoralis, triceps, and biceps, with good outcome and prognosis for shoulder function at 12 months after surgery. This technique provides a unique opportunity for patients suffering from severe brachial plexus injuries and lacking enough donor nerves to obtain shoulder stability and mobility while avoiding bone fusion and preserving functionality of the contralateral shoulder with favorable postoperative outcomes.
Similar content being viewed by others
References
Chuang DCC, Lee GW, Hashem F, Wei FC (1995) Restoration of shoulder abduction by nerve transfer in avulsion brachial plexus injury: evaluation of 99 patients with various nerve transfers. Plast Reconstr Surg 96:122–128
Colbert SH, Mackinnon S (2006) Posterior approach for double nerve transfer for restoration of shoulder function in upper brachial plexus palsy. Hand (NY) 1:71–77
Guan SB, Hou CL, Chen DS, Gu YD (2006) Restoration of shoulder abduction by transfer of the spinal accessory nerve to suprascapular nerve through dorsal approach: a clinical study. Chin Med J (Engl) 119:707–712
Suzuki K, Doi K, Hattori Y, Pagsaligan JM (2007) Long term results of spinal accessory nerve transfer to the suprascapular nerve in upper type paralysis of brachial plexus injury. J Reconstr Microsurg 23:295–300
Venkatramani H, Bhardwaj P, Faruquee SR, Sabapathy SR (2008) Functional outcome of nerve transfer for restoration of shoulder and elbow function in upper brachial plexus injury. J Brachial Plex Peripher Nerve Inj 3:15
Tubbs RS, Mortazavi MM, Shoja MM, Loukas M, Cohen-Gadol AA (2011) Spinal accessory nerve for ipsilateral neurotization of branches of the brachial plexus: a cadaveric feasibility study. J Neurosurg 114:1538–1540
Felici N, Cannatà C, Cigna E, Sorvillo V, Del Bene M (2012) Contralateral spinal accessory nerve: a suitable "new" donor nerve for heterotopic nerve transfer in total brachial plexus palsy. Handchir Mikrochir Plast Chir 44:80–83
Acknowledgments
The authors would like to acknowledge Fabián Romero Ramírez for the contribution of the figures. This study has not received financial support.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zermeño-Rivera, J., Gutiérrez-Amavizca, B.E. Contralateral Spinal Accessory Nerve Transfer: A New Technique in Panavulsive Brachial Plexus Palsy. Indian J Surg 77, 247–250 (2015). https://doi.org/10.1007/s12262-013-1020-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-013-1020-3