Long-term outcome of contralateral C7 transfer: A report of 32 cases

Objective. To observe long-term functional recovery after contralateral C7 transfer. Methods. From August 1986 to July 2000, 224 patients with brachial plexus avulsion injuries were treated with contralateral C7 transfer in our department. Thirty-two patients were followed up for over 2 years for evaluation of the following items: 1 influence on healthy limb function; 2 sensory and motor recovery of the recipient nerves in the affected limb; and 3 coordination between the healthy and affected limbs. Results. There was no impairment of healthy limb function. Functional recovery of the recipient area reached ≥ M3 in 8 patients (8/10, 80%) after musculocutaneous nerve neurotization, ≥ M3 in 4 patients (4/6, 66%) after radial nerve neurotization, ≥ M3 in 7 patients (7/14, 50%) and ≥ S3 in 12 patients (85.7%) after median nerve neurotization, and ≥ M3 in 1 patients (1/2, 50%) after thoracodorsal nerve neurotization. Synchronic contraction of the affected limb with the healthy limb occurred within 2-3 years in 12 patients, within 5 years in 13 patients, and over 5 years in 7 patients. Conclusion. Contralateral C7 transfer is an ideal procedure for the treatment of brachial plexus root avulsion injury. Selection of the whole root or the posterior division as neurotizer and a staged operation are the major factors influencing treatment outcome.