Surgical management of brachial plexus injuries and the experimental reinnervation of the biceps muscle by the spinal motoneurons through acellular nerve graft



Year of publication 1998
Type Article in Proceedings
Conference 7th Congress IFSSH
MU Faculty or unit

Faculty of Medicine

Field Neurology, neurosurgery, neurosciences
Keywords avulsion; acellular nerve graft
Description Thirty six patients with brachial plexus injury have been operated on. Results were very good in the case of infraganglionic lesions in 15 patients. Fair and good results were obtained in 72% of 18 patients with neurotization procedure of musculocutaneous and axillary nerves. Transfer of latissimus dorsi muscle instead of the biceps muscle was successful in another t cases. In the experimental animals the acellular nerve grafts was used to restore a functional reinnervation of the biceps brachii muscle by the motoneuron pool of the cervical spinal cord.. The musculocutaneous nerve stump was sutured with acellular nerve graft, the opposite end of which was inserted into the cervical spinal cord up to the avulsed C5 ventral root. Behavioural, electrophysiological as well as morphological methods proved the reconnection of the spinal motor neurons with the muscle end plates. Our results demonstrate that the acellular nerve graft repopulated by Schwann cells migrating from the nerve stump, stimulates the spinal motoneurons to formation of axonal sprouts. The regenerated axons are able to bridge a 4-cm long originally acellular nerve graft and reinnervate the biceps muscle.
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