J Reconstr Microsurg 2007; 23(6): 295-299
DOI: 10.1055/s-2007-985205
© Thieme Medical Publishers

Long-Term Results of Spinal Accessory Nerve Transfer to the Suprascapular Nerve in Upper-Type Paralysis of Brachial Plexus Injury

Kouichi Suzuki1 , Kazuteru Doi1 , Yasunori Hattori1 , Jose Miguel Pagsaligan1
  • 1Department of Orthopedic Surgery, Ogori Daiichi General Hospital, Yamaguchi, Japan
Further Information

Publication History

Publication Date:
31 October 2007 (online)

ABSTRACT

In the management of upper type of brachial plexus injury, reconstruction to restore shoulder function is accomplished by multiple nerve transfers. We used the accessory nerve to neurotize the suprascapular nerve in 12 patients (11 men, 1 woman) from 1989 to 2003. The average age at the time of operation was 28.1 years (range 16 to 53). The mean preoperative time was 3.6 months. The type of paralysis was C5-C6 type in four cases, C5-C7 type in five cases, and C5-C8 type in three cases. The average time of follow-up was 28.5 months. All the patients showed reinnervation of the supraspinatus and infraspinatus muscles that was confirmed by electromyogram. At the time of final follow-up, the average shoulder flexion was 70.4 degrees and abduction was 77.1 degrees. However, average shoulder external rotation was only 16.7 degrees. We compared the shoulder flexion and abduction in patients with or without paralysis of the serratus anterior muscle and found significantly better functional outcome in the latter group of patients. We, therefore, conclude that repair of long thoracic nerve is mandatory for achieving optimum shoulder function.

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Kouichi SuzukiM.D. 

Department of Orthopedic Surgery, Ogori Daiichi General Hospital

Shimogo 862-3, Ogori-cho, Yoshiki-gun, Yamaguchi 754-0002, Japan