Neurotization for restoration of arm function in complete cervical root avulsion

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Traumatology

Background:

• Traumatic brachial plexus injuries, particularly complete root avulsion, significantly impair upper limb function.
• Restoring motor and sensory function is crucial for patient quality of life.

Purpose of the Study:

• To highlight neurotization as a key reconstructive strategy for traumatic brachial plexus injuries.
• To outline optimal timing and potential donor nerves for neurotization procedures.

Main Methods:

• Utilizing various donor nerves (intercostal, accessory, cervical plexus, phrenic, contralateral C7) for nerve reconstruction.
• Performing neurotization within a critical 3-6 month post-trauma window.
• Considering combination therapies like neurolysis and nerve transplantation.

Main Results:

• Successful neurotization can lead to substantial recovery of shoulder and upper arm motor function.
• Significant improvement in sensory function of the forearm, hand, and fingers is achievable.
• Combined procedures may enhance overall therapeutic benefits.

Conclusions:

• Neurotization is a vital reconstructive option for complete brachial plexus root avulsions.
• Timely neurotization and potential adjunct procedures can restore significant upper limb function.