Cerebral plasticity after contralateral cervical nerve transfer in human by longitudinal PET evaluation

2018 ◽  
Vol 48 ◽  
pp. 95-99 ◽  
Author(s):  
Hao Ma ◽  
Mouxiong Zheng ◽  
Yechen Lu ◽  
Xuyun Hua ◽  
Wendong Xu
Keyword(s):  
Nerve Transfer ◽  
Cervical Nerve ◽  
Cerebral Plasticity

Improved white matter integrity after contralateral seventh cervical nerve transfer measured by tractographic representation

2021 ◽  
pp. 106715
Author(s):  
Hyun-Joo Lee ◽  
Hyun-Sil Cha ◽  
Myong-Hun Hahm ◽  
Huijoong Lee ◽  
Sang Soo Kim ◽  
...  
Keyword(s):  
White Matter ◽  
Nerve Transfer ◽  
White Matter Integrity ◽  
Cervical Nerve

A novel method of lengthening the accessory nerve for direct coaptation during nerve repair and nerve transfer procedures

2018 ◽  
Vol 128 (1) ◽  
pp. 272-276
Author(s):  
R. Shane Tubbs ◽  
Andrés A. Maldonado ◽  
Yolanda Stoves ◽  
Fabian N. Fries ◽  
Rong Li ◽  
...  
Keyword(s):  
Nerve Repair ◽  
Nerve Transfer ◽  
Nerve Fibers ◽  
Accessory Nerve ◽  
Cervical Nerve ◽  
Neural Connections ◽  
Direct Repair ◽  
Novel Method ◽  
Time Distance ◽  
Transfer Procedures

OBJECTIVEThe accessory nerve is frequently repaired or used for nerve transfer. The length of accessory nerve available is often insufficient or marginal (under tension) for allowing direct coaptation during nerve repair or nerve transfer (neurotization), necessitating an interpositional graft. An attractive maneuver would facilitate lengthening of the accessory nerve for direct coaptation. The aim of the present study was to identify an anatomical method for such lengthening.METHODSIn 20 adult cadavers, the C-2 or C-3 connections to the accessory nerve were identified medial to the sternocleidomastoid (SCM) muscle and the anatomy of the accessory nerve/cervical nerve fibers within the SCM was documented. The cervical nerve connections were cut. Lengths of the accessory nerve were measured. Samples of the cut C-2 and C-3 nerves were examined using immunohistochemistry.RESULTSThe anatomy and adjacent neural connections within the SCM are complicated. However, after the accessory nerve was “detethered” from within the SCM and following transection, the additional length of the accessory nerve increased from a mean of 6 cm to a mean of 10.5 cm (increase of 4.5 cm) after cutting the C-2 connections, and from a mean of 6 cm to a mean length of 9 cm (increase of 3.5 cm) after cutting the C-3 connections. The additional length of accessory nerve even allowed direct repair of an infraclavicular target (i.e., the proximal musculocutaneous nerve). The cervical nerve connections were shown not to contain motor fibers.CONCLUSIONSAn additional length of the accessory nerve made available in the posterior cervical triangle can facilitate direct repair or neurotization procedures, thus eliminating the need for an interpositional nerve graft, decreasing the time/distance for regeneration and potentially improving clinical outcomes.

scholarly journals Huashan Perioperative Nursing Program for Stroke Patients Undergoing Contralateral Seventh Cervical Nerve Transfer

2021 ◽  
Author(s):  
Fan Su ◽  
Xiaoqian Wang ◽  
Ye Xu ◽  
Yiqun Zhou ◽  
Wendong Xu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Nerve Transfer ◽  
Nursing Program ◽  
Control Group ◽  
Cervical Nerve ◽  
Spastic Paralysis ◽  
Surgical Safety ◽  
Patient Cooperation ◽  
Nursing Health ◽  
Descriptive Statistical Analysis

Abstract Background: The previous investigation regarding contralateral seventh cervical nerve transfer (CC7) revealed a novel and effective approach to improve arm function in patients with chronic spastic paralysis. The patients who underwent both CC7 and standard rehabilitation showed greater functional improvements and spasticity reductions than did the control group who underwent rehabilitation only. Additional efforts are needed to maximize the benefits in patients and establishing a supporting nursing program is a promising way of achieving this goal.Methods: The present Huashan nursing program was established in consideration of the following elements, that were the routine perioperative care, ensuring surgical safety and improving patient cooperation. Before surgery, psychiatric nursing, health education and risk control were stressed. After surgery, in addition to routine nursing and positioning, special attention was needed for the targeted nursing of postoperative adverse events. In addition, we performed descriptive statistical analysis on the clinical data of patients receiving the Huashan nursing program, focusing on postoperative adverse events. Totally 85 patients were included in the study, and postoperative adverse events occurred in 10 patients, including severe pain (5, 5.88%), neck hematoma (2, 2.35%), dyspnea (2, 2.35%) and hoarseness (1, 1.18%). The above adverse events were alleviated under the targeted nursing guided by the Huashan program.Discussion: This article introduces the Huashan nursing program, which is based on preoperative evaluations, educational sessions, postoperative monitoring and targeted nursing, for patients undergoing CC7. The present nursing program helped the promotion and provided the opportunity to maximize the benefits of CC7.

Long-range plasticity between intact hemispheres after contralateral cervical nerve transfer in humans

2010 ◽  
Vol 113 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Chuan-Tao Zuo ◽  
Xu-Yun Hua ◽  
Yi-Hui Guan ◽  
Wen-Dong Xu ◽  
Jian-Guang Xu ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Brachial Plexus ◽  
Long Range ◽  
Cortical Plasticity ◽  
Nerve Transfer ◽  
Cortical Reorganization ◽  
Injured Limb ◽  
Cervical Nerve ◽  
Human Motor Cortex ◽  
The Right

Object Peripheral nerve injury in a limb usually causes intrahemispheric functional reorganization of the contralateral motor cortex. Recently, evidence has been emerging for significant interhemispheric cortical plasticity in humans, mostly from studies of direct cortical damage. However, in this study, a long-range interhemispheric plasticity was demonstrated in adults with brachial plexus avulsion injury (BPAI) who had received a contralateral cervical nerve transfer, and this plasticity reversed the BPAI-induced intrahemispheric cortical reorganization. Methods In this study, 8 adult male patients with BPAI were studied using PET scanning. Results The results indicated that the right somatomotor cortices, which may contribute to the control of the injured limb before brachial plexus deafferentation, still played an important role when patients with BPAI tried to move their affected limbs, despite the fact that the contralateral C-7 nerve transfer had been performed and the peripheral output had changed dramatically. Such findings are consistent with the results of the authors' previous animal study. Conclusions The brain may try to restore the control of an injured limb to its original cortex area, and a complicated change of peripheral pathway also can induce long-range interhemispheric cortical reorganization in human motor cortex.

Study of the cervical plexus innervation of the trapezius muscle

2011 ◽  
Vol 14 (5) ◽  
pp. 626-629 ◽  
Author(s):  
R. Shane Tubbs ◽  
Mohammadali M. Shoja ◽  
Marios Loukas ◽  
Jeffrey Lancaster ◽  
Martin M. Mortazavi ◽  
...  
Keyword(s):  
Fiber Type ◽  
Trapezius Muscle ◽  
Immunohistochemical Analysis ◽  
Nerve Transfer ◽  
Nerve Fibers ◽  
Spinal Accessory Nerve ◽  
Accessory Nerve ◽  
Type I ◽  
Cervical Nerve ◽  
Spinal Accessory

Object There is conflicting and often anecdotal evidence regarding the potential motor innervation of the trapezius muscle by cervical nerves, with most authors attributing such fibers to proprioception. As knowledge of such potential motor innervations may prove useful to the neurosurgeon, the present study aimed to elucidate this anatomy further. Methods Fifteen adult cadavers (30 sides) underwent dissection of the posterior triangle of the neck and harvesting of cervical nerve fibers found to enter the trapezius muscle. Random fibers were evaluated histologically to determine fiber type (that is, motor vs sensory axons). Results In addition to an innervation from the spinal accessory nerve, the authors also identified cervical nerve innervations of all trapezius muscles. For these innervations, 3 sides were found to have fibers derived from C-2 to C-4, 2 sides had fibers derived from C-2 to C-3, and 25 sides had fibers derived from C-3 to C-4. Fibers derived from C-2 to C-4 were classified as a Type I innervation, those from C-2 to C-3 were classified as a Type II innervation, and those from C-3 to C-4 were classified as a Type III innervation. Immunohistochemical analysis of fibers from each of these types confirmed the presence of motor axons. Conclusions Based on the authors' study, cervical nerves innervate the trapezius muscle with motor fibers. These findings support surgical and clinical experiences in which partial or complete trapezius function is maintained after injury to the spinal accessory nerve. The degree to which these nerves innervate this muscle, however, necessitates further study. Such information may be useful following nerve transfer procedures, denervation techniques for cervical dystonia, or sacrifice of the spinal accessory nerve due to pathological entities.

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