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Experimental Neurotisation of the Brachial Plexus by Means of Nerve Grafting from the Corticospinal Tract of the Proximal Spinal Cord at the T3–T4 LevelFondazione Midollo Spinale, Brescia, Italy Correspondence: Prof. Giorgio A. Brunelli, Fondazione Midollo Spinale, Via Galvani 26, 25123 Brescia, Italy. E-mail:giorgio.brunelli{at}midollospinale.com This paper reports experimental work in rats in which the radial nerve was cut at its origin from the brachial plexus and connected by means of a nerve graft to the corticospinal tract of the spinal cord at the T3–T4 level. After surgery, the triceps and extensor muscles of the forearm were able to extend the elbow and the wrist and gave almost normal responses on EMG. This reinnervation was no longer cholinergic, as demonstrated by the Vecuronium test. Because of the drawbacks associated with implantation into the spinal cord, this technique could not be used in all cases of total avulsion of the brachial plexus but it might be useful in those rare cases in which avulsion of all the cervical nerves of the brachial plexus is associated with paraplegia: such cases are rare but are occasionally seen.
Key Words: spinal cord • brachial plexus avulsions • neurotisation • nerve grafting • corticospinal tract
Journal of Hand Surgery (European Volume), Vol. 32, No. 6,
620-625 (2007) |
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