1. Department of Orthopaedics, Changhai Hospital, the Naval Medical University, Shanghai 200433, China;
2. Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100040, China;
3. Department of Anatomy, the Second Military Medical University, Shanghai 200433, China;
4. Department of Orthopaedics, Jingmen No. 2 People's Hospital, Jingmen 448000, China;
5. Department of Orthopaedics, Qinhuangdao Workers' Hospital, Qinhuangdao 066200, China;
6. Department of Orthopaedics, Tangshan No. 2 Hospital, Tangshan 063000, China;
7. Department of Orthopaedics, Jiaxing Armed Police Force Hospital, Jiaxing 314000, China;
8. Department of Neurosurgery, Yantai Hospital, Binzhou Medical University, Yantai 264100, China;
9. Department of Anatomy, Binzhou Medical University, Binzhou 256600, China;
10. Department of Neurosurgery, North China University of Science and Technology AffiliatedHospital, Tangshan 063000, China;
11. Department of Orthopaedics, Tengzhou Central People's Hospital, Tengzhou 277500, China;
12. Department of Orthopaedics, Jiangsu Armed Police General Hospital, Yangzhou 225003, China;
13. Department of Orthopaedics, the 180th Hospital of PLA, Quanzhou 362008, China
Using nerve segment insert grafting to reconstruct neural pathways of brain-derived paralysis
1. Department of Orthopaedics, Changhai Hospital, the Naval Medical University, Shanghai 200433, China;
2. Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100040, China;
3. Department of Anatomy, the Second Military Medical University, Shanghai 200433, China;
4. Department of Orthopaedics, Jingmen No. 2 People's Hospital, Jingmen 448000, China;
5. Department of Orthopaedics, Qinhuangdao Workers' Hospital, Qinhuangdao 066200, China;
6. Department of Orthopaedics, Tangshan No. 2 Hospital, Tangshan 063000, China;
7. Department of Orthopaedics, Jiaxing Armed Police Force Hospital, Jiaxing 314000, China;
8. Department of Neurosurgery, Yantai Hospital, Binzhou Medical University, Yantai 264100, China;
9. Department of Anatomy, Binzhou Medical University, Binzhou 256600, China;
10. Department of Neurosurgery, North China University of Science and Technology AffiliatedHospital, Tangshan 063000, China;
11. Department of Orthopaedics, Tengzhou Central People's Hospital, Tengzhou 277500, China;
12. Department of Orthopaedics, Jiangsu Armed Police General Hospital, Yangzhou 225003, China;
13. Department of Orthopaedics, the 180th Hospital of PLA, Quanzhou 362008, China
摘要 Since 1992, task groups have used free nerve auto grafts to bridge partially transected nerves from the dominant area of the normal cerebral cortex to nerves that innervate spastic muscles from a diseased cerebral cortex, using transplanting sutures to alleviate the muscle spasm of cerebral palsy caused by different diseases. This has facilitated rebuilding of some of its neurological function. In this study, 80 such patients were followed up, including 20 patients with traumatic brain injury, 32 patients with stroke, and 28 pediatric patients with cerebral palsy. After postoperative follow-up of 3 to 21 years, the efficacy rate of this operation was 100% and the excellent and good spasm relief rate was 82.5%.
Abstract: Since 1992, task groups have used free nerve auto grafts to bridge partially transected nerves from the dominant area of the normal cerebral cortex to nerves that innervate spastic muscles from a diseased cerebral cortex, using transplanting sutures to alleviate the muscle spasm of cerebral palsy caused by different diseases. This has facilitated rebuilding of some of its neurological function. In this study, 80 such patients were followed up, including 20 patients with traumatic brain injury, 32 patients with stroke, and 28 pediatric patients with cerebral palsy. After postoperative follow-up of 3 to 21 years, the efficacy rate of this operation was 100% and the excellent and good spasm relief rate was 82.5%.
20180119183811 Figure 1 Nerve transfer graft surgery.
20180119183817 Figure 2 Nerve transfer graft surgery (graftingC5, 6 to C7, 8).
20180119183825 Figure 3 A healthy cervical C5/C7 was grafted onto an affected C7, restoring wrist extension and finger extension ability on the affected side.
20180119183834 Figure 4 Using ipsilateral C5/C6 nerve roots as donor nerves for C7/C8 as receptors.
20180119183842 Figure 5 For the anterior approach, the method involves introducing two channels from the esophagus to the anterior vertebral body gap and grafting of the superior and middle trunk of the brachial plexus nerve onto the middle and inferior trunk of the brachial plexus nerve on the affected side.
20180119183851 Figure 6 The nerve runs through the holes of the interspinous ligament.
20180119183859 Figure 7 When spastic paralysis was limited to the thighs, L2/L3 were used as the receptor nerves, and L2, 3 as the donor nerves.
20180119183907 Figure 8 When spastic paralysis was limited to the crus, we selected S1 and S2 as receptor nerves, and L5/S1 as the donor nerves.
20180119183917 Table 1 Assessment criteria for assessing limb function
[1] Zhang SC, Zhang YX, Hou HC, Ma YH, Pan YT, Wang LJ, Liu SF, Nian SS. Bridging C5/C7 nerve root and upper trunk with end-to-side neurorrhaphy of grafted nerves in treatment of obstetric palsy. Acad J Sec Mil Med Univ 2001, 22(10): 967-969. [2] Decq P, Filipetti P, Feve A, Saraoui A. Selective peripheral neurotomy of the hamstring branches of the sciatic nerve in the treatment of spastic flexion of the knee. Apropos of a series of 11 patients. Neurochirurgie 1996, 42(6): 275-280. [3] Abdennebi B, Bougatene B. Selective neurotomies for relief of spasticity focalized to the foot and to the knee flexors, results in a series of 58 patients. Acta Neurochir(Wien) 1996, 138(8): 917-920. [4] Sydney S. Nerve and Nerve Injuries. London: Livingston Ltd, 1978. [5] Schmidt CE, Leach JB. Neural tissue engineering: Strategies for repair and regeneration. Annu Rev Biomed Eng 2003, 5: 293-347. [6] Wang XY, Chen L, Ao Q, Sharma A, Sharma HS. Progress in the research and development of nerve conduits. Transl. Neurosci. Clin. 2015, 1(2): 97-101. [7] Zhang SC, Johnston L, Zhang ZW, Ma YH, Hu YH, Wang JL, Huang P, Wang S. Restoration of stepping-forward and ambulatory function in patients with paraplegia: Rerouting of vascularized intercostal nerves to lumbar nerve roots using selected interfascicular anastomosis. Surg Technol Int 2003, 11: 244-248. [8] Zhang SC. Microsurgical management and functional restoration of patients with obsolete spinal cord injury. In Orthopedic Surgery. Zaid AA, Andreas F, eds. Croatia: INTECH, 2012.
2017, Vol. 3 
