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Related Concept Videos

Spinal Nerves: Plexus I01:22

Spinal Nerves: Plexus I

Nerve plexuses are networks of interlacing nerves that serve as communication hubs to distribute and organize nerve action across various body regions. The nerve plexuses are organized into the cervical plexus located in the neck region, brachial plexus in the shoulder area, lumbar plexus found in the lower back, sacral plexus situated in the pelvis, and coccygeal plexus located in the coccygeal region.
The Cervical Plexus
The cervical plexus, formed by the anterior rami of the first four...
Arteries of the Upper Limbs01:12

Arteries of the Upper Limbs

The subclavian artery transitions into the axillary artery as it exits the chest and enters the axillary region. This artery is critical for supplying blood to the shoulder area, including the head of the humerus, through the humeral circumflex arteries. As the vessel continues into the upper arm or brachium, it becomes the brachial artery. This artery plays a key role in vascularizing the brachial region and bifurcates at the elbow into several branches. These branches include the deep...
Spinal Nerves: Plexus II01:21

Spinal Nerves: Plexus II

The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
Spinal Cord Injury ll: Pathophysiology01:14

Spinal Cord Injury ll: Pathophysiology

Spinal cord injury progresses through two interconnected phases: primary injury and secondary injury.Primary InjuryPrimary injury happens at the moment of trauma and involves immediate mechanical damage to the spinal cord.Compression happens when broken vertebrae, herniated discs, or accumulating blood (such as a hematoma) press directly against the spinal cord, distorting its normal shape and function. In cases of contusion, the cord is bruised by a blunt force (like penetrating injuries or...

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Related Experiment Video

Updated: Jun 26, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers
09:34

Structured Motor Rehabilitation After Selective Nerve Transfers

Published on: August 15, 2019

Motor Nerve Transfers in Complete and Incomplete Brachial Plexus Injuries: A State-of-the-Art Review.

Leonardo Bradaschia1,2, Christian Heinen3

  • 1Department of Neuroscience "Rita Levi Montalcini", University of Turin, 10126 Turin, Italy.

Neurology International
|June 25, 2026
PubMed
Summary

Motor nerve transfers offer advanced solutions for brachial plexus injuries (BPI), evolving from proximal to distal strategies. Intraplexal transfers are preferred for better outcomes, while extraplexal donors are crucial for severe BPIs.

Keywords:
coaptationnerve graftnerve transferneurotizationtraumatic injuries

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A Mouse Model of Direct Anastomosis via the Prespinal Route for Crossing Nerve Transfer Surgery
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A Mouse Model of Direct Anastomosis via the Prespinal Route for Crossing Nerve Transfer Surgery

Published on: October 19, 2021

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Last Updated: Jun 26, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers
09:34

Structured Motor Rehabilitation After Selective Nerve Transfers

Published on: August 15, 2019

A Mouse Model of Direct Anastomosis via the Prespinal Route for Crossing Nerve Transfer Surgery
05:56

A Mouse Model of Direct Anastomosis via the Prespinal Route for Crossing Nerve Transfer Surgery

Published on: October 19, 2021

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Brachial plexus injuries (BPI) present complex reconstructive challenges.
  • Nerve transfer surgery has advanced, shifting towards selective distal neurotization for improved functional restoration.
  • Existing literature is fragmented, necessitating a comprehensive overview of current motor nerve transfer strategies.

Purpose of the Study:

  • To provide a state-of-the-art overview of motor nerve transfer strategies for upper-limb reinnervation in BPI.
  • To systematically review and categorize available techniques based on recipient nerve and functional targets.
  • To consolidate fragmented literature for a comprehensive understanding of reconstructive possibilities.

Main Methods:

  • A systematic literature review adhering to PRISMA guidelines was performed.
  • Searches were conducted across major databases: PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science.
  • Included studies were categorized by recipient nerve and functional outcome (shoulder, elbow, wrist, hand function).

Main Results:

  • 250 studies met inclusion criteria, detailing both intraplexal and extraplexal donor nerve transfers.
  • Intraplexal distal nerve transfers are favored for shorter reinnervation and predictable results when feasible.
  • Extraplexal donors (spinal accessory, intercostal, C7, phrenic) are vital for complete BPIs and root avulsions.

Conclusions:

  • Motor nerve transfers are versatile, function-oriented strategies for BPI reconstruction.
  • Intraplexal distal transfers offer advantages, but extraplexal donors remain essential for severe injuries.
  • Restoring intrinsic hand function and achieving reliable distal reinnervation continue to be significant challenges.