Neurosurgery
New research shows that transferring the cervical C7 nerve from the non-paralysed side to the paralysed side in patients after stroke or other brain injuries improves arm function.
New research shows that transferring the cervical C7 nerve from the non-paralysed side to the paralysed side in patients after stroke or other brain injuries improves arm function.
Cervical nerve transfer for arm paralysis
New research has shown that transfer of the cervical C7 nerve from the non-paralysed side to the paralysed side in patients after stroke or other brain injuries leads to improved function and reduced spasticity in the affected arm.
In this centre, in patients who had one-sided arm paralysis from chronic brain injury of more than 5 years, C7 cervical-nerve transfer produced greater improvement in function and reduction in spasticity than rehabilitation alone over 12 months.
Spastic limb paralysis caused by stroke or other hemispheric brain damage leads to long-term disability. Approximately 30%–60% of stroke survivors cannot use their paralysed arm.
The C7 cervical nerve is one of five nerves that form the brachial plexus and contains thousands of nerve fibres. The motor function of the C7 nerve largely overlaps with the activity of the other four nerves, so transection of this nerve usually causes only transient weakness and numbness in the ipsilateral upper limb.
Patients had hemiplegia caused by stroke, traumatic brain injury, cerebral palsy or encephalitis, manifested mainly as spasticity and weakness in the upper limb contralateral to the brain lesion. At the baseline stage before surgery, none of the patients was able to dress, put on shoes, close the hand, hold a towel, or use a telephone with the affected limb.
(Published on 21 December 2017 in the New England Journal of Medicine.)
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