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Neurol India. 2019 Jan-Feb;67(Supplement):S77-S81. doi: 10.4103/0028-3886.250708.

Functional outcome of spinal accessory nerve transfer to the suprascapular nerve to restore shoulder function: Results in upper and complete traumatic brachial plexus palsy in adults.

Author information

1
Peripheral Nerve Surgery Unit, Department of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil.
2
Clinical Neurophysiology, Department of Neurology, University of São Paulo Medical School, São Paulo, SP, Brazil.

Abstract

Background:

Shoulder stability, abduction and external rotation are vital for the performance of usual daily tasks.

Aims:

To compare the functional outcomes in the shoulder following spinal accessory to suprascapular nerve transfer (SASNT).

Patients and Methods:

Comparison of the outcome of adult patients with upper traumatic brachial plexus palsy undergoing SASNT with patients with complete palsy submitted to the same procedure.

Statistical Analysis:

Ranges of motion were compared via the Mann-Whitney U test. The percentages of patients with a favorable outcome were compared by the chi-square test. All tests were two-tailed and P values <0.05 were considered statistically significant.

Results:

SASNT was performed in 76 patients: 23 cases (30.2%) of upper-plexus injuries and 53 cases (69.7%) of complete brachial plexus palsy. Good shoulder abduction was achieved in 15 patients (65.2%) with upper plexus palsy and a good external rotation in 5 (21.7%). In those patients with a good recovery, the average range of motion (ROM) was 53° for shoulder abduction and 71.2° for external rotation. Thirty-six patients (67.9%) with complete palsy had a good shoulder abduction recovery with 30.7° of average ROM, but only 3 patients (5.6%) recovered a good shoulder external rotation with 68.3° of average ROM. There was no statistical difference for the abduction outcome, but the external rotation outcome was superior in the upper plexus palsy group.

Conclusion:

SASNT is a consistent procedure to achieve functional recovery of shoulder abduction after a partial or complete plexus injury, but the outcomes of external rotation were quite disappointing in both the groups.

KEYWORDS:

Brachial plexus palsy; brachial plexus surgery; nerve transfers

PMID:
30688238
DOI:
10.4103/0028-3886.250708
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