title: Contralateral Spinal Accessory Nerve Transfer: A New Technique in Panavulsive Brachial Plexus Palsy.
abstract: Brachial plexus avulsion results from excessive stretching and can occur secondary to motor vehicle accidents, mainly in motorcyclists. In a 28-year-old man with panavulsive brachial plexus palsy, we describe an alternative technique to repair brachial plexus avulsion and to stabilize and preserve shoulder function by transferring the contralateral spinal accessory nerve to the suprascapular nerve. We observed positive clinical and electromyographic results in sternocleidomastoid, trapezius, supraspinatus, infraspinatus, pectoralis, triceps, and biceps, with good outcome and prognosis for shoulder function at 12 months after surgery. This technique provides a unique opportunity for patients suffering from severe brachial plexus injuries and lacking enough donor nerves to obtain shoulder stability and mobility while avoiding bone fusion and preserving functionality of the contralateral shoulder with favorable postoperative outcomes.
authors.affiliation: Servicio de Cirugía Reconstructiva del Instituto Jalisciense de Cirugía Reconstructiva "Dr. José Guerrerosantos", Federalismo Norte 2022, Guadalupana, 44220 Guadalajara, Jalisco Mexico ; Vida integra, control de diabetes y obesidad, José María Heredia 2964, Col. Prados Providencia, C.P. 44670 Guadalajara, Jalisco Mexico.
authors.forename: Jaime
authors.initials: J
authors.lastname: Zermeño-Rivera
authors.affiliation: División de Genética, Centro de Investigación Biomédica de Occidente, IMSS; Doctorado en Genética Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 800. Col. Independencia, 44340 Guadalajara, Jalisco Mexico.
authors.forename: Bianca Ethel
authors.initials: BE
authors.lastname: Gutiérrez-Amavizca
keywords: Brachial plexus; Nerve transfer; Neurolysis; Spinal accessory