Spinal accessory neurotization for restoration of elbow flexion in avulsion injuries of the brachial plexus

ABSTRACT

Avulsion injury of the brachial plexus is a disease of middle-aged population and is associated with psychological and economical problems. The present study demonstrates our 10-year experience with spinal accessory neurotization for restoration of elbow flexion in affected subjects in Tehran. During this clinical trial, 32 patients undertook spino-bicipital procedure, of whom 14 were treated with fascia lata to transmit biceps force to 2[nd]-5[th] flexors. Three years later patients were reevaluated for flexor performance.Medical Research Council [MRC] grading for these patients were as follow; MRC4 21 patients [67%], MRC3 8[25%], MRC2 2[6%] and MRC1 in one patient [3%]. Of 14 MRC4-patients who were treated with fascia lata, 9 [64%] could carry a 9kg weight and 5 [36%] could carry a 4kg weight. Elbow flexion of 90? and wrist flexion of 25-30 were seen in all patients.Spinal accessory neurotization can be safely employed for restoration of elbow flexion in avulsion injuries of the brachial plexus