Coaptation of the Anterior Ramus of C4 to the C5 Root for Cervical Nerve Root Avulsion.

Kim, Sang Jin

Original Article

Journal of Korean Neurosurgical Society 1993;22(10): 1148-1152.

Department of Neurosurgery, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea.

ABSTRACT

There is no surgical procedure, which has been available to repair cervical nerve root avulsion inside the spinal canal. Several nerve grafts and muscle transfer had performed. In some patients, neurotization with nerve coaptation, ofter refered to as 'anastomosis' of the intercostals to the musculocutaneous nerve has restored useful function of biceps, but other muscles remained paralyzed. However no procedure has been available to allow recovery to function of the entire groups of muscles. The author have performed bridge-graft coaptation in a patient with C-5 nerve root avulsion. The components of the coaptation included the anterior primary ramus of C-4 as the donor material, the C-5 root as the recipient, and the sural nerve graft as the gridge. After operation, functional recovery occurred in the muscles innervated by the C-5 root and sensation improved. This procedure is effective and recommended as a new approach to treatment of cervical nerve avulsion and proximal brachial plexopathy.

Key Words: Brachial plexus injury; Avulsion injury; Coaptation; Nerve graft