同侧C_7神经根移位后对其支配肌影响的初步观察

Influence of ipsilateral C_7 nerve root transfer on its innervating muscles : a preliminary report

目的 观察C7神经移位后对C7神经根所支配肌肉功能的影响。方法 1996年 2月至 2 0 0 0年 2月 ,对 7例臂丛上干或C5,6神经根损伤患者 ,均采用同侧C7神经根 (全部 )移位修复 ;并观察手术前、后背阔肌、肱三头肌及指总伸肌肌力及肌电的变化。术后 1周 7例 ,术后 4个月 6例 ,术后 1年 5例进行了肌力测定及肌电检查。结果 术后 1周背阔肌、肱三头肌及指总伸肌的肌力较术前均有所下降 ,下降幅度多在 1级以内。肌力的下降均呈可逆性 ,术后 4个月三块肌肉的肌力均已恢复正常。术后 3个时间组三块肌肉CMAP(复合肌肉动作电位 )的波幅、潜伏期和术前比无明显影响。结论 臂丛上干损伤采用同侧C7移位后 ,供区背阔肌肌力下降最明显 ,肱三头肌次之 ,指总伸肌最小。

Objective To observe influence of ipsilateral C 7 transfer on C 7 innervating muscles. Methods From February 1996 to February 2000, ipsilateral C 7 transfer were performed in seven cases of upper trunk or C 5,6 nerve roots injury. Muscle strength (latissimus dorsi, triceps brachii, extensor digitorum communis muscle) and electrophysioloical changes were observed pre and post operatively.There were 7 cases at postoperative 1 week,6 cases at 4 months, 5 cases at 1 year respectively. Results Muscle strength of C 7 innervating muscles(latissimus dorsi, triceps brachii, extensor digitorum communis muscle) diminished a little with the extent within one grade 1 week after the operation. The decrease of muscle strength was reversible. The muscle strength of the above mentioned three muscle was restored to normal at postoperative month 4. There was no obvious change in amplitude and latent period in CMAP at 3 postoperative time interval in comparison with preoperative one. Conclusions After ipsilateral C 7 transfer was done for brachial plexus upper trunk injury , the most obvious decrease of muscle strength was latissimus dorsi, then followed by triceps brachii and extensor digitorum communis muscle.