Reconstruction of shoulder and elbow function using multiple muscle transfers for cervical spondylotic amyotrophy.

Study Design: This was a retrospective study of 8 patients with cervical spondylotic amyotrophy who underwent multiple muscle transfers.

Objective: The purpose of this study was to evaluate results of multiple muscle transfers about the shoulder and elbow in patients with cervical spondylotic amyotrophy.

Summary Of Background Data: Cervical spondylotic amyotrophy is characterized by severe muscle atrophy of the shoulder girdle and elbow. Even after cervical spine surgery, many patients have poor shoulder and elbow function.

Methods: Multiple muscle transfer procedures including the transfer of trapezius, pectoralis major, latissimus dorsi muscles, and the Steindler procedure for reconstruction of shoulder and elbow function were performed in 8 patients with cervical spondylotic amyotrophy. Patients were evaluated at a mean of 18.2 months (range, 5-75 mo).

Results: All 8 patients obtained satisfactory functional recovery with improvement of active range of motion without any systemic and local complications within 3 to 6 months postoperatively. Patients at the last follow-up had obtained a mean of 91° of shoulder abduction, 111° of shoulder flexion, 23° of external rotation and 110° of elbow flexion. Disability scores (Japanese version) of the arm, shoulder, and hand improved by a mean of 28 points.

Conclusion: Multiple muscle transfers can improve shoulder and elbow function in cervical spondylotic amyotrophy, in cases of not only poor outcome after cervical surgery, but also in advanced paralysis. It is a useful set of procedures even in old patients, and provides definitive functional improvement of shoulder and elbow function from 3 to 6 months.

Level Of Evidence: 4.