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Contralateral C7 nerve root transfer in treatment of cerebral palsy in a child: case report
Wen-Dong Xu1, Xu-Yun Hua, Mou-Xiong Zheng
1Department of Hand Surgery, Hua-Shan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. wendongxu88@yahoo.com.cn
Insights
This study shows that combining C7 nerve root rhizotomy and nerve transfer surgery can reduce spasticity and improve arm function in children with cerebral palsy.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Reconstructive Surgery
Background:
- Hemiplegic cerebral palsy often causes severe upper extremity spasticity.
- Limited treatment options exist for improving motor function in affected limbs.
Observation:
- A 4-year-old girl with left hemiplegic cerebral palsy underwent a novel surgical procedure.
- The surgery involved C7 nerve root rhizotomy and contralateral C7 nerve root transfer using a sural nerve graft.
Findings:
- Two-year follow-up revealed reduced spasticity and improved elbow, wrist, and finger extension power.
- Significant improvements were noted in Quality of Upper Extremity Skills Test and Modified Ashworth Scale scores.
Implications:
- This combined surgical approach may effectively manage spasticity and enhance motor function in pediatric cerebral palsy.
- The findings support C7 nerve root procedures as a viable option for improving upper extremity function in this population.
Abstract:
A 4-year-old girl who sustained the hemiplegic cerebral palsy and subsequent spasticity in the left upper extremity underwent the C7 nerve root rhizotomy and the contralateral C7 nerve root transfer to the ipsilateral middle trunk of brachial plexus through an interpositional sural nerve graft. In a 2-year follow-up, the results showed a reduction in spasticity and an improvement in extension power of the elbow, the wrist, and the second to fifth fingers. Scores from both Quality of Upper Extremity Skills Test and Modified Ashworth Scale tests had been significantly improved during follow-up. The outcomes from this case provided the evidence that combined the C7 nerve root rhizotomy and contralateral healthy C7 nerve root transfer to the ipsilateral middle trunk of brachial plexus not only partially released flexional spasticity but also strengthened extension power of the spastic upper extremity in children with the cerebral palsy.
