Coaptation of the anterior rami of C-3 and C-4 to the upper trunk of the brachial plexus for cervical nerve root avulsion

1991 ◽  
Vol 74 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Shokei Yamada ◽  
Gordon W. Peterson ◽  
Donald S. Soloniuk ◽  
A. Douglas Will
Keyword(s):  
Brachial Plexus ◽  
Nerve Root ◽  
Shoulder Girdle ◽  
Brachial Plexopathy ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
Shoulder Girdle Muscles

✓ No surgical procedure has been available to repair cervical nerve root avulsion inside the spinal canal. Results with peripheral neurotization of denervated muscles have been discouraging. The authors have performed bridge-graft coaptation in three patients with C-5 and C-6 nerve root avulsion. The components of the coaptation included the anterior primary rami of C-3 and C-4 as the donor material, the entire upper trunk as the recipient, and the sural nerve graft as the bridge. This procedure resulted in restoration of motor function in the biceps and shoulder-girdle muscles and produced improved sensation. Stimulation of the C-3 and C-4 nerve roots elicited electrical responses in the biceps and deltoid muscles that indicated nerve growth through the graft and the brachial plexus into these muscles. This reconstructive procedure is effective and should stimulate development of new approaches to treatment of cervical nerve root avulsion and proximal brachial plexopathy.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

Cervical nerve root avulsion in brachial plexus injuries: magnetic resonance imaging classification and comparison with myelography and computerized tomography myelography

2002 ◽  
Vol 96 (3) ◽  
pp. 277-284 ◽  
Author(s):  
Kazuteru Doi ◽  
Ken Otsuka ◽  
Yukinori Okamoto ◽  
Hiroshi Fujii ◽  
Yasunori Hattori ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Brachial Plexus ◽  
Nerve Root ◽  
Brachial Plexus Injury ◽  
Root Avulsion ◽  
Cervical Nerve ◽  
Ct Myelography ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
Fine Print

Object. The authors describe a new magnetic resonance (MR) imaging technique to demonstrate the status of the cervical nerve roots involved in brachial plexus injury. They discuss the accuracy and reproducibility of a MR imaging—derived classification for diagnosis of nerve root avulsion compared with those of myelography combined with computerized tomography (CT) myelography. Methods. The overlapping coronal—oblique slice MR imaging procedure was performed in 35 patients with traumatic brachial plexus injury and 10 healthy individuals. The results were retrospectively evaluated and classified into four major categories (normal rootlet, rootlet injuries, avulsion, and meningocele) after confirming the diagnosis by surgical exploration with or without spinal evoked potential (EP) measurements and by referring to myelography and CT myelography findings. The reliability and reproducibility of the MR imaging—based classification was prospectively assessed by eight independent observers, and its diagnostic accuracy was compared with that of traditional myelography/CT myelography classification, correlated with surgical and spinal EP findings in another 50 cervical roots in 10 patients with traumatic brachial plexus injury. Conclusions. In the retrospective study in which MR imaging and myelography/CT myelography findings involving 175 cervical roots in 35 patients were compared, the sensitivity of detection of the cervical nerve root avulsion was the same (92.9%) with both modalities. In the prospective study, interobserver reliability and intraobserver reproducibility showed that there was no statistically significant difference between MR imaging and myelography/CT myelography and that their accuracy for detecting cervical root avulsion was the same as that in the retrospective study. The overlapping coronal—oblique slice MR imaging technique is a reliable and reproducible method for detecting nerve root avulsion. The information provided by this modality enabled the authors to assess the roots of the brachial plexus and provided valuable data for helping to decide whether to proceed with exploration, nerve repair, primary reconstruction, or other imaging modalities.

scholarly journals A new cervical nerve root avulsion model using a posterior extra-vertebral approach in rats

2014 ◽  
Vol 08 (01) ◽  
pp. e19-e27 ◽  
Author(s):  
Takashi Noguchi ◽  
Souichi Ohta ◽  
Ryosuke Kakinoki ◽  
Yukitoshi Kaizawa ◽  
Shuichi Matsuda
Keyword(s):  
Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Nerve Root Avulsion

CT Myelography in Cervical Nerve Root Avulsion

1985 ◽  
Vol 9 (2) ◽  
pp. 275-279 ◽  
Author(s):  
Adam F. Petras ◽  
David F. Sobel ◽  
John R. Mani ◽  
Phillip R. Lucas
Keyword(s):  
Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Ct Myelography ◽  
Nerve Root Avulsion

Bypass Coaptation Procedures for Cervical Nerve Root Avulsion

Neurosurgery ◽  
1996 ◽  
Vol 38 (6) ◽  
pp. 1145-1152 ◽  
Author(s):  
Shokei Yamada ◽  
Russell R. Lonser ◽  
Robert P. Iacono ◽  
John D. Morenski ◽  
Leonard Bailey
Keyword(s):  
Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Nerve Root Avulsion

scholarly journals High noon back pain- severe pseudoradicular pain as a lead symptom of superficial siderosis: a case report

2014 ◽  
Vol 7 (6) ◽  
pp. 276-278 ◽  
Author(s):  
Carsten Saft ◽  
Ines Siglienti ◽  
Ralf Gold ◽  
Marc Schlamann ◽  
Nicolai El Hindy ◽  
...  
Keyword(s):  
Back Pain ◽  
Nerve Root ◽  
Superficial Siderosis ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
First Case ◽  
Severe Back Pain ◽  
Nerve Root Avulsion ◽  
Superficial Hemosiderosis

A superficial siderosis of the central nervous system following a traumatic cervical nerve root avulsion usually leads to gait difficulties and hearing loss, whereas back pain is described only rarely. Here we report on the first case with circadian occurrence of severe back pain as the only symptom of a superficial siderosis. We present a case with the most severe pseudoradicular lumbosacral pain occurring daily at noon for the past 5 weeks. The 48-year-old male white patient did not complain of pain in the morning. A traumatic root avulsion 26 years earlier led to a brachial plexus palsy and Horner’s syndrome in this patient. Superficial hemosiderosis in cranial MRI and examination of the cerebrospinal fluid revealing massive red blood cells as well as xanthochromia and elevated protein levels (742 mg/l) led to the diagnosis of a superficial siderosis. A pseudomeningocele caused by a cervical nerve root avulsion is described as a rare reason for superficial siderosis. Surgery on a pseudomeningocele, diagnosed by MRI, led to an immediate disappearance of complaints in our case. Regular neurological investigation and possibly repeated lumbar puncture to exclude superficial siderosis should be considered in cases with severe back pain and a history of traumatic root avulsion. Modern susceptibility weighted MR imaging (SWI) techniques, sensible to the detection of superficial hemosiderosis, might be helpful in the making of a diagnosis.

Post-traumatic cervical nerve root avulsion: direct and indirect magnetic resonance myelography findings

2015 ◽  
Vol 15 (9) ◽  
pp. 2103-2104 ◽  
Author(s):  
Alaaddin Nayman ◽  
Egemen Altan ◽  
Mustafa Koplay ◽  
Ali Sami Kıvrak
Keyword(s):  
Magnetic Resonance ◽  
Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Nerve Root Avulsion ◽  
Post Traumatic
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