Neurotization in Brachial Plexus Injury
DOI:
https://doi.org/10.18270/rsb.v11i1.3238Keywords:
Brachial plexus; para, Wallerian degeneration, brachial plexus, neurotization, nerve transfer, peripheral nervous system diseasesAbstract
Understanding brachial plexus injury and its surgical treatment represents a challenge for medical personnel for it requires an adequate interpretation of the anatomy, histology, and pathophysiology of the peripheral nerve and its respective repair mechanisms. Neurotization is a biological phenomenon, where axonal extensions colonize the injured peripheral nerve to sustain the cell's function. This event is favored in certain surgical techniques, such as primary neurorrhaphy, nerve grafts and nerve transfers.
These techniques are most widely used today for brachial plexus and peripheral nerve injuries, and if performed correctly taking into consideration a broad knowledge of the morphology of compromised tissues, they provide an opportunity for motor and/or sensory recovery with excellent functional results.
The following article presents the anatomy of the brachial plexus, peripheral nerve and the physiological bases of nerve repair process to understand the principles of neurotization, and its surgical interventions in brachial plexus injury.
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Latarjet M. Anatomía de miembro superior. En: Latarjet M, Ruiz-Liard A, editores. Anatomía Humana. 4ª ed. Buenos Aires: Panamericana; 2004. p.630-72.
Drake RL. Miembro Superior. En: Drake RL, Vogl AW, Mitchell AWM, editores. Gray anatomía para estudiantes. 2a ed. Barcelona: Elsevier; 2012. p.690-774.
Quesada-Brenes F. Valoración del daño corporal lesión completa e irreversible del plexo braquial. Med. leg. Costa Rica. 2016; 33(2):165-77.
Midha R. Epidemiology of brachial plexus injuries in a multitrauma population. Neurosurgery. 1997; 40(6): 1182-9. DOI: 10.1097/00006123-199706000-00014
Meals RA, Nelissen RG. The origin and meaning of "neurotization". J Hand Surg Am. 1995; 20(1): 144-6. DOI: 10.1016/S0363-5023(05)80072-3
Sunderland S. The anatomy and physiology of nerve injury. Muscle Nerve. 1990; 13(9):771-84. DOI: 10.1002/mus.880130903
Seddon HJ. A Classification of Nerve Injuries. Br Med J. 1942 Aug 29;2(4260):237-9. DOI: 10.1136/bmj.2.4260.237
Robla-Costales J, Socolovsky M, Di Masi G, Domitrovic L, Campero A, Fernández-Fernández J, Ibáñez-Plágaro, J, García-Cosamalón J. Técnicas de reconstrucción nerviosa en cirugía del plexo braquial traumatizado Parte 1: Transferencias nerviosas extraplexuales. Neurocirugía. 2011; 22(6):507-20.
Marrero-Riverón LO, Cabrera-Viltres N, Rodríguez--Triana Orueja JA, Navarro-González A, Castro-Soto Del Valle A, Tarragona-Reinoso R, Hernández-Gutiérrez R. Diagnóstico y tratamiento de la parálisis braquial y obtstérica. Rev Cuba Ortop Traumatol. 1998; 12(1-2): 28-39.
Kierszenbaum A. Histology and cell biology: an introduction to pathology. 4th ed. Philadelphia: Elsevier; 2016.
Ross MH, Negrete J, Pawlina W. Tejido Nervioso. En:. Ross MH, Pawlina W, editores. Histología: texto y atlas color con biología celular y molecular. 6ª ed. Buenos Aries: Editorial Médica Panamericana; 2012. p. 352-98.
Gartner LP, Hiatt JL. Color textbook of histology. 3th ed. Philadelphia: Sauders/Elsevier; 2007.
Reina MA, López A, Villanueva MC, Andrés JA de, León GI. Morfología de los nervios periféricos, de sus cubiertas y de su vascularización. Rev. esp. anestesiol. Reanim. 2000; 47(10): 464-75.
Rotshenker S. Wallerian degeneration: the innate-immune response to traumatic nerve injury. J Neuroinflammation. 2011; 8:109.
DOI: 10.1186/1742-2094-8-109.
Zhai Q, Wang J, Kim A, Liu Q, Watts R, Hoopfer E, Mitchison T, Luo L, He Z. Involvement of the ubiquitin-proteasome system in the early stages of wallerian degeneration. Neuron. 2003; 39(2):217-25.
DOI: 10.1016/s0896-6273(03)00429-x
Nieto Ramírez LE, Torres Arciniegas SC, Ríos Rosado EC, Torres Jiménez IA, Camargo Casas SD. Célula de Büngner. Univ Med. 2017;58(1). https://doi.org/10.11144/Javeriana.umed58-1.cbun
Toy D, Namgung U. Role of glial cells in axonal regeneration. Exp Neurobiol. 2013 Jun;22(2):68-76.
DOI: 10.5607/en.2013.22.2.68
Allodi I, Udina E, Navarro X. Specificity of peripheral nerve regeneration: Interactions at the axon level. Prog Neurobiol. 2012; 98(1):16-37.
DOI: 10.1016/j.pneurobio.2012.05.005
Vergara-Amador E. Qué hacer en el trauma del plexo braquial. Conceptos actuales. Salud uninorte. 2014; 30(3): 483-97. DOI:10.14482/sun.30.3.5759
Green D. Nerve injury and repair, Traumatic Braquia Plexus injury. In: Wolfe S, Pederson W, Kozin S, Cohen M, editors. Green´s operative hand surgery. 7th. Philadelphia: Elsevier; 2017. p 979-1023,1146-200.
Sumarwoto T, Suroto H, Mahyudin F, Utomo DN, Hadinoto SA, Abdulhamid M, Utomo P, Romaniyanto R, Prijosedjati RA, Rhatomy S. Brachial plexus injury: recent diagnosis and management. Open Access Maced J Med Sci. 2021; 9(F):13-24.
DOI: https://doi.org/10.3889/oamjms.2021.5578
Zancolli P, Solano-Pérez RJ, Barraza-Arrambide RH, Clifton-Correa JF, López-Almejo L, Espinosa- de los Monteros Kelley AF, Rodríguez-Martínez RE. Lesión total de plexo braquial de nacimiento. Orthotips. 2020; 16(4):173-81. DOI: 10.35366/97816
Bravo-Aguilera C, Carpintero-Lluch R, Delgado-Martínez AD. Técnicas actuales de reparación nerviosa. Rev. S. And. Traum. y Ort., 2016; 33 (3/4): 21-8
Pabari A, Yang SY, Seifalian AM, Mosahebi A. Modern surgical management of peripheral nerve gap. J Plast Reconstr Aesthet Surg. 2010; 63(12):1941-8.
DOI: 10.1016/j.bjps.2009.12.010
Doi K. Distal nerve transfer: perspective of reconstructive microsurgery. J Reconstr Microsurg. 2018; 34(9): 675-7. DOI: 10.1055/s-0038-1639369
Tung TH. Nerve transfers. Clin Plast Surg. 2014; 41(3):551-9. DOI: 10.1016/j.cps.2014.04.002
Martínez-Martínez F, Ñiguez-Sevilla B, García-García J, García-López A. Técnicas de transferencia nerviosa en lesiones del miembro superior. Rev Iberoam Cir Mano. 2017; 45(1): 57-67. DOI:10.1055/s-0037-1602765
Moore AM. Nerve transfers to restore upper extremity function: a paradigm shift. Front Neurol. 2014; 5:40.
DOI: 10.3389/fneur.2014.00040
Vanaclocha-Vanaclocha V, Ortiz-Criado J, Sáiz-Sapena N, Vanaclocha N. Nerve transfers in the treatment of peripheral nerve injuries. En: Maurício AC, editor. Peripheral nerve regeneration - from surgery to new therapeutic approaches including biomaterials and cell-based therapies development. 1a ed. Croatia: IntechOpen; 2017. p.67-98.
Lee SK, Wolfe SW. Nerve transfers for the upper extremity: new horizons in nerve reconstruction. J Am Acad Orthop Surg. 2012; 20(8): 506-17.
DOI: 10.5435/JAAOS-20-08-506
Tung TH, Novak CB, Mackinnon SE. Nerve transfers to the biceps and brachialis branches to improve elbow flexion strength after brachial plexus injuries. J Neurosurg. 2003; 98(1): 313-38.
DOI: 10.3171/jns.2003.98.2.0313
Oberlin C, Béal D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994 Mar;19(2):232-7.
DOI: 10.1016/0363-5023(94)90011-6
Rezende MR, Silva GB, Paula EJ, Mattar Junior R, Camargo OP. What has changed in brachial plexus surgery? Clinics (Sao Paulo). 2013;68(3):411-8.
DOI: 10.6061/clinics/2013(03)r02
Robla-Costales J, Socolovsky M, Di Masi G, Robla-Costales D, Domitrovic L, Campero A, Fernández-Fernández J, Ibáñez-Plágaro J, García-Cosamalón J. Técnicas de reconstrucción nerviosa en cirugía del plexo braquial traumatizado Parte 2: Transferencias nerviosas intraplexuales. Neurocirugía. 2011; 22(6): 521-4. https://doi.org/10.1016/S1130-1473(11)70107-5
Ferraresi S, Garozzo D, Buffatti P. Reinnervation of the biceps in C5-7 brachial plexus avulsion injuries: results after distal bypass surgery. Neurosurg Focus. 2004;16(5): E6. 4.
DOI: 10.3171/foc.2004.16.5.7
Boyd KU, Nimigan AS, Mackinnon SE. Nerve reconstruction in the hand and upper extremity. Clin Plast Surg. 2011; 38(4): 643-60.
DOI: 10.1016/j.cps.2011.07.008
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