Introduction/aims: Cervical spinal cord injury (SCI) significantly impairs upper limb function, affecting patients' quality of life. Nerve transfer surgery can restore arm and hand function, but its success depends on the health of infralesional lower motor neurons (LMNs). LMN abnormalities are prevalent in muscles targeted for nerve transfer, particularly those innervated by the posterior interosseous nerve (PIN) and radial nerve, essential for wrist extension and hand opening. This study evaluates the health of infralesional LMNs in cervical SCI using multipoint stimulation motor unit number estimation (MPS-MUNE). We assessed motor unit counts in the C7-innervated anconeus and the predominantly C8-innervated extensor indicis (EI) to determine their viability as targets for nerve transfer surgery.
Methods: We conducted a prospective, two-center cohort study using MPS-MUNE to evaluate 15 individuals with cervical SCI (26 limbs) and 17 healthy controls.
Results: Compound muscle action potential (CMAP) and MUNE values were significantly lower in SCI patients compared to controls (EI CMAP: 2.0 mV ± 1.57, EI MUNE: 33 ± 30.5; anconeus CMAP: 2.7 mV ± 1.9, anconeus MUNE: 39 ± 50.6 versus controls: EI CMAP: 6.6 mV ± 1.0, EI MUNE: 137 ± 33.9; anconeus CMAP: 6.6 mV ± 1.3, anconeus MUNE: 146 ± 42.3). Test-retest reliability for EI and anconeus were 0.84 (CI: 0.45-0.95) and 0.78 (CI: 0.36-0.93), respectively.
Discussion: Significant LMN loss was observed after cervical SCI. MPS-MUNE shows potential for evaluating LMN health, highlighting its importance for assessing nerve transfer targets and planning interventions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/mus.28373 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
From surgical problem to surgical solution - lessons and reflections.
J Hand Surg Eur Vol
March 2025
Department of Surgery, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
In this insightful and personal biographical article, Professor Bertelli recounts his journey from surgical problem to surgical solution with incredible detail. This was an invited article as part of the 2025 Special Issue on 'Technology and Innovation'. He shares some of this thought process behind novel nerve transfer or examination techniques, built on solid anatomical foundations and careful patient observations.
View Article and Find Full Text PDFGenetic or therapeutic disruption of the Reelin/Apoer2 signaling pathway improves inflammatory arthritis outcomes.
Proc Natl Acad Sci U S A
March 2025
Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390-9046.
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation, pannus formation, and progressive joint destruction. The inflammatory milieu in RA drives endothelial cell activation and upregulation of adhesion molecules, thus facilitating leukocyte infiltration into the synovium. Reelin, a circulating glycoprotein previously implicated in endothelial activation and leukocyte recruitment in diseases such as atherosclerosis and multiple sclerosis, has emerged as a potential upstream regulator of these processes.
View Article and Find Full Text PDFVascularized fibular epiphyseal transfer for biological reconstruction of bone defects following resection in children with proximal humeral sarcoma.
BMC Surg
March 2025
Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, P. R. China.
Background: The functional reconstruction of bone defects following resection of proximal humerus tumors in children poses a significant challenge. This study utilized vascularized fibular epiphyseal transfer for proximal humerus reconstruction to evaluate the outcome, complications, and survival rates.
Methods: In this study, we conducted a retrospective analysis of 13 pediatric patients who underwent vascularized fibular epiphyseal transfer for biological reconstruction following oncologic resection of the proximal humerus between 2019 and 2021.
Evaluating motor unit properties after nerve transfer surgery.
J Neurol Sci
February 2025
International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Experimental Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Division of Physical Medicine & Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Nerve transfer surgery (NTS) shows promise in restoring movement to muscles paralyzed by spinal cord (SCI) and peripheral nerve injury (PNI). Yet, motor outcomes vary, and the neurophysiological factors influencing responders and non-responders remain unclear. As the fundamental goal of NTS is to reinnervate paralyzed muscles by creating new motor units (MUs), we examined MU properties after NTS for individuals with SCI and PNI.
View Article and Find Full Text PDFObjective: Restoration of axillary nerve function is one of the main priorities of brachial plexus surgery. Neurotization, the transfer of a functional but less important donor nerve to a nonfunctional, more important recipient nerve, has become a leading treatment option. A variety of donor nerves, from different segmental levels of the spinal cord, have been used to reinnervate the axillary nerve.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!