Contralateral C7Nerve Pathway By The Treatment Of Posterior Anatomy Of The Brachial Plexus Injury

Objective: Anatomical study by the contralateral C7nerve transfer for treatment of thecontralateral vertebral channel avulsion brachial plexus feasibility.Methods: Take10formalin fixed cadavers were male7and female3, specimen noobvious deformity, defect-free tissue, neck neutral position, surgical exploration of brachialplexus injury simulation mode, the length of contralateral C7nerve root was elongated bydissecting its anterior and posterior division to the distal end,while measurement of C7nerve Since the intervertebral foramen to the root issue at length and sub-unit after unitlength; simulated cervical posterior surgical approach, fully exposed to the C6and C7cervical, and in the meantime near the vertebral body side drilling, measurement therequired length from Posterior pathway to the contralateral upper trunk and lower trunk.Results:1.The anatomy of the posterior pathwayC7for cervical and thoracic junction area, the physiological curvature of the thoraciccurveover by the neck curved to take the line in the sagittal plane to go back below linewith thethoracic,8~10°angle between the C7transverse processtubercle very small orabsent,turned to the rear of the C7nerve entrapment and to a certain extent can reduce thenervebypass distance; With thoracic intervertebral disc degeneration of the cervical spinejoint thicker, spinous gap width1.8~2.6cm, far more than the diameter of the C7nerveroot, the C7nerve easily through the; Cervical lateral flexion, proneness and extensionactivities without oppression of nerve, and cervical spinous channels have protectiveeffects on the nervous, so the neck activities postoperatively to the influence of very small.2.Distance measurement resultsC7nerve root length (58.62±8.70) mm, plus the length of the later shares (65.15±9.11) mm,plus the length of the former shares (70.03±10.79) mm. Through theposterior pathway,the distances from the end of C7nerve to contralateral upper trunk ofbrachial plexus (72.12±10.22) mm, to the contralateral lower trunk of brachial plexus (95.21±12.50) mm.Conclusion: Contralateral C7nerve can shift through the posterior approach to thecontralateral side, only need a short bridge nerve,this pathway can effectively avoid thewhole road damage blood vessels, vertebral nerve and the way the complications ofsurgery which may led by the prespinal pathway, so the posterior approach may becomethe other way of treatment of brachial plexus root avulsed injury surgery.