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. 2012 Mar;154(3):527-32.
doi: 10.1007/s00701-011-1264-2. Epub 2012 Jan 5.

Side-to-side neurorrhaphy for high-level peripheral nerve injuries

ShaoCheng Zhang  1 , Fang Ji, DaKe Tong, Ming Li
Affiliations

Side-to-side neurorrhaphy for high-level peripheral nerve injuries

ShaoCheng Zhang et al. Acta Neurochir (Wien). 2012 Mar.

Abstract

Background: The results of peripheral nerve repair, especially for high-level peripheral nerve injuries, have been unsatisfactory. The method of side-to-side neurorrhaphy was developed in our laboratory from 1994 to 2002. This method involves suturing the injured nerve to a nearby donor nerve in a side-to-side manner. This study was performed to assess the clinical results of side-to-side neurorrhaphy in patients with high-level peripheral nerve injuries.

Methods: Twenty-five patients with various types of high-level peripheral nerve injuries who underwent side-to-side neurorrhaphy were studied. The British Medical Research Council (BMRC) scale was used to assess recovery of nerve function.

Results: Average follow-up duration was 3.2 years. Before surgery the patients had a nerve function of M0/S0 to M1/S1. After side-to-side neurorrhaphy, 7 patients had a score of M3/S4, 8 patients a score of M3/S3 and 10 patients a score of M2/S3. The total useful recovery rate (BMRC grade ≥3) was 60% for motor function and 100% for sensory function. Side-to-side neurorrhaphy did not result in any significant loss of donor nerve function. There was significant correlation between both the type of injury and the time interval between injury and surgery and motor nerve function. Age, gender and location of the injured nerve did not correlate with sensory or motor nerve function.

Conclusion: Side-to-side neurorrhaphy appears to be promising as a feasible method for repair of high-level peripheral nerve injuries.

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Figures

Fig. 1
Fig. 1
Schematic diagram of side-to-side neurorrhaphy: a. Epineurium incision of two neighboring nerves. b. Suture on one side of the epineurium. c. Incision of the perineurium. d. Suture on one side of the perineurium. e. Suture on another side of the perineurium. f. Suture on another side of the epineurium
Fig. 2
Fig. 2
Outcome of the surgery. a. The injured point and side-to-side neurorrhaphy position during surgery. b. Functional recovery was demonstrated at 3-year follow-up after surgery
See this image and copyright information in PMC

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