title: Motor function of the upper-extremity after transection of the second thoracic nerve root during total en bloc spondylectomy.
abstract: BACKGROUND
  In total en bloc spondylectomy (TES) of upper thoracic spine including the second thoracic (T2) vertebra, T2 nerve roots are usually transected. In this study, we examined the association between transection of the T2 nerve roots and upper-extremity motor function in patients with upper thoracic TES.
  
  
  METHODS
  We assessed 16 patients who underwent upper thoracic TES with bilateral transection of the T2 nerve roots. Patients were divided into three groups: 3 patients without any processing of T1 and upper nerve roots (T2 group), 7 with extensive dissection of T1 nerve roots (T1-2 group), and 6 with extensive dissection of T1 and upper nerve roots (C-T2 group). Postoperative upper-extremity motor function was compared between the groups.
  
  
  RESULTS
  Postoperative deterioration of upper-extremity motor function was observed in 9 of the 16 patients (56.3%). Three of the 7 patients in the T1-2 group and all 6 patients in the C-T2 group showed deterioration of upper-extremity motor function, but there was no deterioration in the T2 group. In the T1-2 group, 3 patients showed mild deterioration that did not affect their activities of daily living and they achieved complete recovery at the latest follow-up examination. In contrast, severe dysfunction occurred frequently in the C-T2 group, without recovery at the latest follow-up.
  
  
  CONCLUSIONS
  The transection of the T2 nerve roots alone did not result in upper-extremity motor dysfunction; rather, the dysfunction is caused by the extensive dissection of the T1 and upper nerve roots. Therefore, transection of the T2 nerve roots in upper thoracic TES seems to be an acceptable procedure with satisfactory outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yokogawa
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Murakami
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Demura
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kato
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Katsuhito
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ishii
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Moriyuki
authors.initials: M
authors.lastname: Fujii
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Igarashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Takara-machi, Kanazawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D019637:Orthopedic Procedures / Q000379:methods*; D013125:Spinal Neoplasms / Q000503:physiopathology / Q000601:surgery; D013126:Spinal Nerve Roots / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery*; D034941:Upper Extremity / Q000503:physiopathology*