Donor complications of contralateral C7 nerve transfer in Brachial Plexus Birth Injury: a systematic review,Child's Nervous System

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Donor complications of contralateral C7 nerve transfer in Brachial Plexus Birth Injury: a systematic review
Child's Nervous System ( IF 1.3 ) Pub Date : 2023-06-27 , DOI: 10.1007/s00381-023-06047-3
M Jakeman ₁ , G H Borschel ₂ , P Sharma ₁

Affiliation

Purpose

Contralateral C7 (CC7) nerve transfer is a reconstructive option in the upper limb when there are limited donor options. Promising results have been reported in the adult population but its role in Brachial Plexus Birth Injury (BPBI) is unclear. A major concern with this technique is the potential impact on the contralateral, unaffected limb. Our aim was to review the available literature on the use of this transfer in BPBI, to determine the incidence of short- and long-term deficits at the donor site.

Methods

The relevant literature was identified from searches of Embase, Ovid Emcare and Ovid MEDLINE, for combinations of terms relating to CC7 nerve transfer and BPBI.

Results

Seventy-five patients were included in this review, from the eight papers that were eligible for inclusion, from a total of 16 papers identified. Patient age ranged from three to 93 months and the shortest follow-up period was six months. Post-operative motor deficits at the donor site included reduced range of shoulder abduction; triceps weakness; and phrenic nerve palsy. All motor deficits recovered within six months. The only sensory deficit reported was reduced sensation in the median nerve distribution which, in all cases, resolved within four weeks. Finally, synchronous donor limb motion and sensation were reported in 46.6% of patients.

Conclusion

CC7 nerve transfer in BPBI appears to have few long-term donor limb complications. Sensory and motor deficits are reportedly transient. The impact of synchronous motion and sensation on upper limb function in this patient cohort is not yet known.

中文翻译：

臂丛神经出生损伤中对侧 C7 神经移植的供体并发症：系统评价

目的

当供体选择有限时，对侧 C7 (CC7) 神经移植是上肢的重建选择。在成年人群中已报告了有希望的结果，但其在臂丛神经出生损伤 (BPBI) 中的作用尚不清楚。该技术的一个主要问题是对对侧未受影响肢体的潜在影响。我们的目的是回顾有关在 BPBI 中使用这种移植的现有文献，以确定供体部位短期和长期缺陷的发生率。

方法

相关文献是通过 Embase、Ovid Emcare 和 Ovid MEDLINE 的搜索找到的，其中包含与 CC7 神经转移和 BPBI 相关的术语组合。

结果

本次综述纳入了 75 名患者，这些患者来自 8 篇符合纳入条件的论文，总共确定了 16 篇论文。患者年龄从 3 个月到 93 个月不等，最短随访期为 6 个月。供体部位术后运动缺陷包括肩部外展范围缩小；三头肌无力；和膈神经麻痹。所有运动缺陷均在六个月内恢复。据报道，唯一的感觉缺陷是正中神经分布的感觉减弱，在所有情况下，这种感觉都在四个星期内得到解决。最后，46.6% 的患者报告了同步供体肢体运动和感觉。