Nerve root transfer from C4 to C5 in brachial plexus injuries. Anatomical study and description of the surgical technique^[*]

Abstract

Objective This is an anatomical study of C4 and C5 roots for nerve transfers in upper brachial plexus injuries, with surgical technique demonstration.

Methods Fifteen brachial plexuses from both male and female cadavers were dissected. Morphological features of C4 and C5 roots were recorded and analyzed, followed by a neurotization simulation.

Results In all dissections, C4 and C5 roots morphological features allowed their mobilization and neurotization with no need for a nerve graft. The surgical technique spared important regional nerve branches.

Conclusion Based on these data, we conclude that C4-C5 nerve transfers are feasible and result in no additional neurological deficit in upper brachial plexus injuries.

Keywords

brachial plexus - cervical plexus - nerve transfer - spinal nerve roots

Financial Support

There was no financial support from public, commercial, or non-profit sources.

^* Study performed at the Orthopedics and Traumatology Department, Hospital da Irmandade da Santa Casa da Misericórdia de São Paulo (DOT/ISCMSP), São Paulo, SP, Brazil.

Publication History

Received: 17 June 2020

Accepted: 14 October 2020

Article published online:
31 March 2021

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