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Surgical Technique: Spinal Accessory to Infraspinatus Nerve Transfer in Brachial Plexus Birth Injury
Heather R Burns1,2, Tanir A Moreno1,2, Alexandra L McLennan1,2
1Michael E. DeBakey Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine.
Techniques in Hand & Upper Extremity Surgery
|September 13, 2024
Summary
This study refines a nerve transfer technique to improve shoulder external rotation in brachial plexus birth injuries. The modified spinal accessory nerve to infraspinatus transfer shows promising outcomes for restoring shoulder function.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Pediatric Surgery
Background:
- Restoring shoulder external rotation in brachial plexus birth injuries is challenging.
- Traditional nerve surgery techniques like spinal accessory nerve to suprascapular nerve transfers yield suboptimal results.
- A more distal nerve transfer to the infraspinatus branch of the suprascapular nerve has shown encouraging mid-term outcomes.
Purpose of the Study:
- To describe a modified, distal nerve transfer technique for shoulder external rotation restoration.
- To provide detailed intraoperative guidance through step-by-step photographs.
Main Methods:
- Modification of the spinal accessory nerve transfer directly to the infraspinatus branch.
- Detailed intraoperative photographic documentation of the surgical steps.
Main Results:
- The modified technique offers a more targeted approach for nerve reconstruction.
- Mid-term outcomes of similar distal transfers are encouraging, suggesting potential for improved functional recovery.
Conclusions:
- This modified nerve transfer technique presents a refined surgical option for brachial plexus birth injuries.
- Further evaluation is needed to confirm the efficacy and long-term benefits of this specific modification.
