Restoring movement to paralyzed limbs by treating nerve root avulsion: a seven year retrospective

Traumatic injury of major nerve roots of extremities paralyzes the limb and causes high degree of disability. The aim of the study was to evaluate outcomes of surgical treatment of upper and lower limb nerve root avulsion using various microsurgical techniques to reconstruct the function of the extremity. 31 contralateral nerve transfer surgeries were performed on 17 patients with upper and lower extremities nerve root avulsion. Neurological and EMG examinations were carried out. To assess the return of function in the patient's hand Medical Research Council grading systems were used; to evaluate the return of function in the patient's leg we developed special microsurgical techniques. Excellent and good outcomes were received after thoracodorsal to musculocutaneous, spinal accessory to suprascapular or axillar in comparison to unlar to median or femoral transfer. Spinal accessory to suprascapular nerve transfer revealed better shoulder abduction than in case of spinal accessory to axillary transfer. It is concluded that contralateral nerve transfer represents a reliable and potent neurotizer that allows restoration of paralyzed limb function in surgical treatment of nerve root avulsion. Early reveal the better outcome.