Abstract：
OBJECTIVE: Nerve transfers to restore or augment function after spinal cord injury is an expanding field. There is a paucity of information, however, on the use of nerve transfers for patients having undergone spine surgery. The incidence of neurologic deficit after spine surgery is rare but extremely debilitating. The purpose of this study was to describe the functional benefit after upper extremity nerve transfers in the setting of nerve injury after cervical spine surgery.
METHODS: A single-center retrospective review of all patients who underwent nerve transfers after cervical spine surgery was completed. Patient demographics, injury features, spine surgery procedure, nerve conduction and electromyography study results, time to referral to nerve surgeon, time to surgery, surgical technique and number of nerve transfers performed, complications, postoperative muscle testing, and subjective outcomes were reviewed.
RESULTS: Fourteen nerve transfers were performed in 6 patients after cervical spine surgery. Nerve transfer procedures consisted of a transfer between a median nerve branch of flexor digitorum superficialis into a biceps nerve branch, an ulnar nerve branch of flexor carpi ulnaris into a brachialis nerve branch, a radial nerve branch of triceps muscle into the axillary nerve, and the anterior interosseous nerve into the ulnar motor nerve. Average patient age was 55 years; all patients were male and underwent surgery on their left upper extremity. Average referral time was 7 months, average time to nerve transfer was 9 months, and average follow-up was 21 months. Average preoperative muscle grading was 0.9 of 5, and average postoperative muscle grading was 4.1 of 5 ( P < 0.00001).
CONCLUSIONS: Upper extremity peripheral nerve transfers can significantly help patients regain muscle function from deficits secondary to cervical spine procedures. The morbidity of the nerve transfers is minimal with measurable improvements in muscle function.
METHODS: A single-center retrospective review of all patients who underwent nerve transfers after cervical spine surgery was completed. Patient demographics, injury features, spine surgery procedure, nerve conduction and electromyography study results, time to referral to nerve surgeon, time to surgery, surgical technique and number of nerve transfers performed, complications, postoperative muscle testing, and subjective outcomes were reviewed.
RESULTS: Fourteen nerve transfers were performed in 6 patients after cervical spine surgery. Nerve transfer procedures consisted of a transfer between a median nerve branch of flexor digitorum superficialis into a biceps nerve branch, an ulnar nerve branch of flexor carpi ulnaris into a brachialis nerve branch, a radial nerve branch of triceps muscle into the axillary nerve, and the anterior interosseous nerve into the ulnar motor nerve. Average patient age was 55 years; all patients were male and underwent surgery on their left upper extremity. Average referral time was 7 months, average time to nerve transfer was 9 months, and average follow-up was 21 months. Average preoperative muscle grading was 0.9 of 5, and average postoperative muscle grading was 4.1 of 5 ( P < 0.00001).
CONCLUSIONS: Upper extremity peripheral nerve transfers can significantly help patients regain muscle function from deficits secondary to cervical spine procedures. The morbidity of the nerve transfers is minimal with measurable improvements in muscle function.
摘要：
目的：脊髓损伤后神经转移以恢复或增强功能是一个扩展的领域。信息匮乏,然而,关于脊柱手术患者神经转移的使用。脊柱手术后神经功能缺损的发生率很少，但非常虚弱。这项研究的目的是描述在颈椎手术后神经损伤的背景下上肢神经转移后的功能益处。
方法：对所有颈椎手术后接受神经转移的患者进行单中心回顾性分析。患者人口统计学，损伤特征,脊柱外科手术,神经传导和肌电图研究结果，是时候转诊给神经外科医生了，手术时间到了,手术技术和神经转移的数量，并发症,术后肌肉测试，并对主观结果进行了审查。
结果：6例患者在颈椎手术后进行了14次神经移植。神经转移程序包括在趾浅屈的正中神经分支之间转移到肱二头肌神经分支，尺侧腕屈肌的尺神经分支进入肱神经分支，三头肌的桡神经分支进入腋下神经，和骨间前神经进入尺运动神经。患者平均年龄为55岁；所有患者均为男性，左上肢接受手术。平均转诊时间为7个月，神经转移的平均时间为9个月，平均随访21个月。术前平均肌肉分级为5分之0.9，术后平均肌肉分级为5分之4.1（P<0.00001）。
结论：上肢周围神经转移可显著帮助患者从颈椎手术继发的肌肉功能恢复。神经转移的发病率最小，肌肉功能有可测量的改善。
方法：对所有颈椎手术后接受神经转移的患者进行单中心回顾性分析。患者人口统计学，损伤特征,脊柱外科手术,神经传导和肌电图研究结果，是时候转诊给神经外科医生了，手术时间到了,手术技术和神经转移的数量，并发症,术后肌肉测试，并对主观结果进行了审查。
结果：6例患者在颈椎手术后进行了14次神经移植。神经转移程序包括在趾浅屈的正中神经分支之间转移到肱二头肌神经分支，尺侧腕屈肌的尺神经分支进入肱神经分支，三头肌的桡神经分支进入腋下神经，和骨间前神经进入尺运动神经。患者平均年龄为55岁；所有患者均为男性，左上肢接受手术。平均转诊时间为7个月，神经转移的平均时间为9个月，平均随访21个月。术前平均肌肉分级为5分之0.9，术后平均肌肉分级为5分之4.1（P<0.00001）。
结论：上肢周围神经转移可显著帮助患者从颈椎手术继发的肌肉功能恢复。神经转移的发病率最小，肌肉功能有可测量的改善。
