caa a22 4500 606213732 CHVBK 20210128101048.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00701-015-2387-7 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2387-7 The phrenic nerve as a donor for brachial plexus injuries: is it safe and effective? Case series and literature analysis [Elektronische Daten] [Mariano Socolovsky, Gilda di Masi, Gonzalo Bonilla, Miguel Paez, Javier Robla, Camilo Cabrera] Background: Controversy exists surrounding the use of the phrenic nerve for transfer in severe brachial plexus injuries. The objectives of this study are: (1) to present the experience of the authors using the phrenic nerve in a single institution; and (2) to thoroughly review the existing literature to date. Methods: Adult patients with C5-D1 and C5-C8 lesions and a phrenic nerve transfer were retrospectively included. Patients with follow-up shorter than 18months were excluded. The MRC muscle strength grading system was used to rate the outcome. Clinical repercussions relating to sectioning of the phrenic nerve were studied. An intense rehabilitation program was started after surgery, and compliance to this program was monitored using a previously described scale. Statistical analysis was performed with the obtained data. Results: Fifty-one patients were included. The mean time between trauma and surgery was 5.7months. Three-quarters of the patients had C5-D1, with the remainder C5-C8. Mean post-operative follow-up was 32.5months A MRC of M4 was achieved in 62.7% patients, M3 21.6%, M2 in 3.9%, and M1 in 11.8%. The only significant differences between the two groups were in graft length (9.8 vs. 15.1cm, p = 0.01); and in the rehabilitation compliance score (2.86 vs. 2.00, p = 0.01). Conclusions: Results of phrenic nerve transfer are predictable and good, especially if the grafts are short and the rehabilitation is adequate. It may adversely affect respiratory function tests, but this rarely correlates clinically. Contraindications to the use of the phrenic nerve exist and should be respected. Springer-Verlag Wien, 2015 Brachial plexus injury nationallicence Phrenic nerve nationallicence Extraplexual transfer nationallicence Nerve transfer nationallicence Socolovsky Mariano Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut di Masi Gilda Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut Bonilla Gonzalo Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut Paez Miguel Neurosurgical Department, Hospital Regional Universitario Carlos Haya, Málaga, Spain aut Robla Javier Neurosurgical Department, Hospital de León, León, Spain aut Cabrera Camilo Neurosurgical Department, Hospital de la Sabana, Bogotá, Colombia aut Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 1077-1086 0001-6268 157:6<1077 2015 157 701 https://doi.org/10.1007/s00701-015-2387-7 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2387-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Socolovsky Mariano Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut NATIONALLICENCE 700 1- di Masi Gilda Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut NATIONALLICENCE 700 1- Bonilla Gonzalo Nerve & Plexus Surgery Program, Division of Neurosurgery, University of Buenos Aires School of Medicine, Buenos Aires, Argentina aut NATIONALLICENCE 700 1- Paez Miguel Neurosurgical Department, Hospital Regional Universitario Carlos Haya, Málaga, Spain aut NATIONALLICENCE 700 1- Robla Javier Neurosurgical Department, Hospital de León, León, Spain aut NATIONALLICENCE 700 1- Cabrera Camilo Neurosurgical Department, Hospital de la Sabana, Bogotá, Colombia aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/6(2015-06-01), 1077-1086 0001-6268 157:6<1077 2015 157 701