Contralateral C7 Nerve Root Transfer for Function Recovery in Adults: A Meta-analysis.

Area of Science:

• Neurosurgery
• Reconstructive Surgery
• Nerve Transfer Techniques

Background:

• Brachial plexus avulsion injury (BPAI) presents a significant reconstructive challenge.
• Contralateral C7 (CC7) nerve transfer is a debated surgical option for BPAI since 1986.
• This meta-analysis evaluates CC7 nerve transfer efficacy for motor and sensory recovery.

Purpose of the Study:

• To meta-analyze surgical outcomes of CC7 nerve transfer in BPAI.
• To assess motor and sensory recovery rates following CC7 nerve transfer.
• To identify optimal recipient nerves for CC7 nerve transfer.

Main Methods:

• Systematic literature search using English and Chinese keywords in multiple databases.
• Inclusion of clinical research articles; exclusion of animal studies and duplicates.
• Assessment of motor (MRC ≥ M3) and sensory (MRC ≥ S3) recovery.

Main Results:

• Overall motor recovery rate: 57% (CI: 0.48-0.66); sensory recovery rate: 52% (CI: 0.46-0.58).
• Recipient median nerve: motor recovery 50% (CI: 0.39-0.61), sensory recovery 56% (CI: 0.50-0.63).
• Recipient musculocutaneous nerve: motor recovery 74% (CI: 0.65-0.82); radial nerve: motor recovery 50% (CI: 0.31-0.70).

Conclusions:

• Contralateral C7 nerve transfer to the musculocutaneous nerve provides the best functional recovery.
• CC7 is a reliable donor nerve for upper limb reconstruction in complete BPAI.
• Combining musculocutaneous and median nerves as recipients may enhance outcomes.