The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures

Cadaveric feasibility study - Laboratory investigation

R. Shane Tubbs, Marios Loukas, Mohammadali Mohajel Shoja, Ghaffar Shokouhi, John C. Wellons, W. Jerry Oakes, Aaron A. Cohen-Gadol

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Object. Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors' knowledge, not been previously explored. Methods. In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of nerve was then tunneled subcutaneously and contralaterally across the neck to a supra- and infraclavicular exposure of the suprascapular and musculocutaneous nerves. Measurements were made of the length and diameter of the LTN. Results. All specimens were found to have a LTN that could be brought to the aforementioned contralateral nerves. Neural connections remained tension free with left and right neck rotation of ∼ 45°. The mean length of the LTN was 22 cm with a range of 18-27 cm. The overall mean diameter of this nerve was 3.0 mm. No gross evidence of injury to surrounding neurovascular structures was identified in any specimen. Conclusions. Based on the results of this cadaveric study, the use of the contralateral LTN may be considered for neurotization of the proximal musculocutaneous and suprascapular nerves.

Original languageEnglish (US)
Pages (from-to)749-753
Number of pages5
JournalJournal of Neurosurgery
Volume110
Issue number4
DOIs
StatePublished - Apr 1 2009
Externally publishedYes

Fingerprint

Thoracic Nerves
Nerve Transfer
Brachial Plexus
Feasibility Studies
Arm
Tissue Donors
Musculocutaneous Nerve
Neck
Clavicle
Cadaver
Wounds and Injuries

Keywords

  • Brachial plexus
  • Neurotization
  • Trauma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures : Cadaveric feasibility study - Laboratory investigation. / Tubbs, R. Shane; Loukas, Marios; Mohajel Shoja, Mohammadali; Shokouhi, Ghaffar; Wellons, John C.; Oakes, W. Jerry; Cohen-Gadol, Aaron A.

In: Journal of Neurosurgery, Vol. 110, No. 4, 01.04.2009, p. 749-753.

Research output: Contribution to journalArticle

Tubbs, R. Shane ; Loukas, Marios ; Mohajel Shoja, Mohammadali ; Shokouhi, Ghaffar ; Wellons, John C. ; Oakes, W. Jerry ; Cohen-Gadol, Aaron A. / The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures : Cadaveric feasibility study - Laboratory investigation. In: Journal of Neurosurgery. 2009 ; Vol. 110, No. 4. pp. 749-753.
@article{2c9ec5f5fce04f3f9341ec99e6276149,
title = "The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures: Cadaveric feasibility study - Laboratory investigation",
abstract = "Object. Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors' knowledge, not been previously explored. Methods. In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of nerve was then tunneled subcutaneously and contralaterally across the neck to a supra- and infraclavicular exposure of the suprascapular and musculocutaneous nerves. Measurements were made of the length and diameter of the LTN. Results. All specimens were found to have a LTN that could be brought to the aforementioned contralateral nerves. Neural connections remained tension free with left and right neck rotation of ∼ 45°. The mean length of the LTN was 22 cm with a range of 18-27 cm. The overall mean diameter of this nerve was 3.0 mm. No gross evidence of injury to surrounding neurovascular structures was identified in any specimen. Conclusions. Based on the results of this cadaveric study, the use of the contralateral LTN may be considered for neurotization of the proximal musculocutaneous and suprascapular nerves.",
keywords = "Brachial plexus, Neurotization, Trauma",
author = "Tubbs, {R. Shane} and Marios Loukas and {Mohajel Shoja}, Mohammadali and Ghaffar Shokouhi and Wellons, {John C.} and Oakes, {W. Jerry} and Cohen-Gadol, {Aaron A.}",
year = "2009",
month = "4",
day = "1",
doi = "10.3171/2008.4.17511",
language = "English (US)",
volume = "110",
pages = "749--753",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "4",

}

TY - JOUR

T1 - The contralateral long thoracic nerve as a donor for upper brachial plexus neurotization procedures

T2 - Cadaveric feasibility study - Laboratory investigation

AU - Tubbs, R. Shane

AU - Loukas, Marios

AU - Mohajel Shoja, Mohammadali

AU - Shokouhi, Ghaffar

AU - Wellons, John C.

AU - Oakes, W. Jerry

AU - Cohen-Gadol, Aaron A.

PY - 2009/4/1

Y1 - 2009/4/1

N2 - Object. Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors' knowledge, not been previously explored. Methods. In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of nerve was then tunneled subcutaneously and contralaterally across the neck to a supra- and infraclavicular exposure of the suprascapular and musculocutaneous nerves. Measurements were made of the length and diameter of the LTN. Results. All specimens were found to have a LTN that could be brought to the aforementioned contralateral nerves. Neural connections remained tension free with left and right neck rotation of ∼ 45°. The mean length of the LTN was 22 cm with a range of 18-27 cm. The overall mean diameter of this nerve was 3.0 mm. No gross evidence of injury to surrounding neurovascular structures was identified in any specimen. Conclusions. Based on the results of this cadaveric study, the use of the contralateral LTN may be considered for neurotization of the proximal musculocutaneous and suprascapular nerves.

AB - Object. Various donor nerves, including the ipsilateral long thoracic nerve (LTN), have been used for brachial plexus neurotization procedures. Neurotization to proximal branches of the brachial plexus using the contralateral long thoracic nerve (LTN) has, to the authors' knowledge, not been previously explored. Methods. In an attempt to identify an additional nerve donor candidate for proximal brachial plexus neurotization, the authors dissected the LTN in 8 adult human cadavers. The nerve was transected at its distal termination and then passed deep to the clavicle and axillary neurovascular bundle. This passed segment of nerve was then tunneled subcutaneously and contralaterally across the neck to a supra- and infraclavicular exposure of the suprascapular and musculocutaneous nerves. Measurements were made of the length and diameter of the LTN. Results. All specimens were found to have a LTN that could be brought to the aforementioned contralateral nerves. Neural connections remained tension free with left and right neck rotation of ∼ 45°. The mean length of the LTN was 22 cm with a range of 18-27 cm. The overall mean diameter of this nerve was 3.0 mm. No gross evidence of injury to surrounding neurovascular structures was identified in any specimen. Conclusions. Based on the results of this cadaveric study, the use of the contralateral LTN may be considered for neurotization of the proximal musculocutaneous and suprascapular nerves.

KW - Brachial plexus

KW - Neurotization

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=65649123045&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=65649123045&partnerID=8YFLogxK

U2 - 10.3171/2008.4.17511

DO - 10.3171/2008.4.17511

M3 - Article

VL - 110

SP - 749

EP - 753

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 4

ER -