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Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting.

Publication ,  Journal Article
Tse, R; Marcus, JR; Curtis, CG; Dupuis, A; Clarke, HM
Published in: Plast Reconstr Surg
June 2011

BACKGROUND: The purpose of this study was to determine whether there is any difference in external rotation following reconstruction of the suprascapular nerve using nerve grafts from the proximal C5 root or nerve transfer using the spinal accessory nerve. METHODS: External rotation was assessed using the Active Movement Scale immediately before surgery and 3 years postoperatively. Patients with less than 3 years of follow-up were excluded. For patients who underwent secondary shoulder surgery before the 3-year follow-up, the Active Movement Scale score before shoulder surgery was used as the outcome. RESULTS: One-hundred-six patients underwent nerve grafting, while 71 patients underwent spinal accessory nerve transfer. The spinal accessory nerve transfer group had a greater proportion of patients with total plexus palsies, more avulsions, and an earlier age at surgery (p < 0.001). In the C5 nerve graft group, the mean Active Movement Scale score increased from 0.4 to 2.2 (p < 0.001). In the nerve transfer group, the mean score increased from 0.2 to 3.0 (p < 0.001). Preoperatively, the C5 nerve graft group had significantly better scores than the nerve transfer group (p = 0.03). Postoperatively, there was no significant difference between treatments (p = 0.1). Further statistical analysis failed to demonstrate a significant advantage of one surgical treatment over the other. CONCLUSIONS: There was no difference in external rotation after suprascapular nerve reconstruction with either nerve grafting from the proximal C5 root or spinal accessory nerve transfer. The choice of suprascapular nerve reconstruction can be selected depending on specific requirements of the individual lesion.

Duke Scholars

Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

June 2011

Volume

127

Issue

6

Start / End Page

2391 / 2396

Location

United States

Related Subject Headings

  • Trigeminal Nerve
  • Treatment Outcome
  • Surgery
  • Spinal Nerve Roots
  • Shoulder Joint
  • Range of Motion, Articular
  • Paralysis, Obstetric
  • Nerve Transfer
  • Male
  • Infant
 

Citation

APA
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ICMJE
MLA
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Tse, R., Marcus, J. R., Curtis, C. G., Dupuis, A., & Clarke, H. M. (2011). Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting. Plast Reconstr Surg, 127(6), 2391–2396. https://doi.org/10.1097/PRS.0b013e3182131c7c
Tse, Raymond, Jeffrey R. Marcus, Christine G. Curtis, Annie Dupuis, and Howard M. Clarke. “Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting.Plast Reconstr Surg 127, no. 6 (June 2011): 2391–96. https://doi.org/10.1097/PRS.0b013e3182131c7c.
Tse R, Marcus JR, Curtis CG, Dupuis A, Clarke HM. Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting. Plast Reconstr Surg. 2011 Jun;127(6):2391–6.
Tse, Raymond, et al. “Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting.Plast Reconstr Surg, vol. 127, no. 6, June 2011, pp. 2391–96. Pubmed, doi:10.1097/PRS.0b013e3182131c7c.
Tse R, Marcus JR, Curtis CG, Dupuis A, Clarke HM. Suprascapular nerve reconstruction in obstetrical brachial plexus palsy: spinal accessory nerve transfer versus C5 root grafting. Plast Reconstr Surg. 2011 Jun;127(6):2391–2396.

Published In

Plast Reconstr Surg

DOI

EISSN

1529-4242

Publication Date

June 2011

Volume

127

Issue

6

Start / End Page

2391 / 2396

Location

United States

Related Subject Headings

  • Trigeminal Nerve
  • Treatment Outcome
  • Surgery
  • Spinal Nerve Roots
  • Shoulder Joint
  • Range of Motion, Articular
  • Paralysis, Obstetric
  • Nerve Transfer
  • Male
  • Infant