Neural Regeneration Research ›› 2018, Vol. 13 ›› Issue (1): 94-99.doi: 10.4103/1673-5374.224376

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 Is it necessary to use the entire root as a donor when transferring contralateral C7 nerve to repair median nerve?

Kai-ming Gao1, 2, 3, Jie Lao1, 2, 3, Wen-jie Guan1, 2, 3, Jing-jing Hu4   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
    3 Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
    4 Nursing Department, Huashan Hospital, Fudan University, Shanghai, China
  • Received:2017-10-16 Online:2018-01-15 Published:2018-01-15
  • Contact: Jie Lao, M.D., Ph.D.,laojie633@sina.com.
  • Supported by:

    This study was supported by the National Natural Science Foundation of China, No. H0605/81501871.

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Abstract:

If a partial contralateral C7 nerve is transferred to a recipient injured nerve, results are not satisfactory. However, if an entire contralateral C7  nerve is used to repair two nerves, both recipient nerves show good recovery. These findings seem contradictory, as the above two methods use the same donor nerve, only the cutting method of the contralateral C7  nerve is different. To verify whether this can actually result in different repair effects, we divided rats with right total brachial plexus injury into three groups. In the entire root group, the entire contralateral C7  root was transected and transferred to the median nerve of the affected limb. In the posterior division group, only the posterior division of the contralateral C7  root was transected and transferred to the median nerve. In the entire root + posterior division group, the entire contralateral C7  root was transected but only the posterior division was transferred to the median nerve. After neurectomy,the median nerve was repaired on the affected side in the three groups. At 8, 12, and 16 weeks postoperatively, electrophysiological examination showed that maximum amplitude, latency, muscle tetanic contraction force, and muscle fiber cross-sectional area of the flexor digitorum superficialis muscle were significantly better in the entire root and entire root + posterior division groups than in the posterior division group. No significant difference was found between the entire root and entire root + posterior division groups. Counts of myelinated axons in the median nerve were greater in the entire root group than in the entire root + posterior division group, which were greater than the posterior division group. We conclude that for the same recipient nerve, harvesting of the entire contralateral C7  root achieved significantly better recovery than partial harvesting, even if only part of the entire root was used for transfer. This result indicates that the entire root should be used as a donor when transferring contralateral C7  nerve.

Key words: nerve regeneration, peripheral nerve injury, brachial plexus injury, avulsion injury, contralateral C7 transfer, nerve root, entire root, partial root, median nerve, ulnar nerve, animal experiment, neural regeneration