Long term outcome of contralateral C7 transfer: a report of 32 cases

To observe long-term functional recovery after contralateral C7 transfer.

From August 1986 to July 2000, 224 patients with brachial plexus avulsion injuries were treated with contralateral C7 transfer in our department. Thirty-two patients were followed up for over 2 years for evaluation of the following items: 1 influence on healthy limb function; 2 sensory and motor recovery of the recipient nerves in the affected limb; and 3 coordination between the healthy and affected limbs.

There was no impairment of healthy limb function. Functional recovery of the recipient area reached > or =M3 in 8 patients (8/10, 80%) after musculocutaneous nerve neurotization, > or =M3 in 4 patients (4/6, 66%) after radial nerve neurotization, > or = M3 in 7 patients (7/14, 50%) and > or = M3 in 12 patients (85.7%) after median nerve neurotization, and > or = M3 in 1 patients (1/2, 50%) after thoracodorsal nerve neurotization. Synchronic contraction of the affected limb with the healthy limb occurred within 2-3 years in 12 patients, within 5 years in 13 patients, and over 5 years in 7 patients.

Contralateral C7 transfer is an ideal procedure for the treatment of brachial plexus root avulsion injury. Selection of the whole root or the posterior division as neurotizer and a staged operation are the major factors influencing treatment outcome.