The Anatomical Study For Repair Of Injuries Of Bachial Plexus In Spinal Canal

Objective:It is frequent that injury of brachial plexus occurred in foramina. If the remnant ventral root in spinal canal can be applied, the procedure of repair should be efficient. The aim of this experiment is to design a new therapeutic option for repair of injures of brachial plexus and explore it's superiority, feasibility, adaptation and complication through autopsy and modeling operation.Methods:The bilateral brachial plexus were exposed on 15 cadaveric specimens of adult. Following data were measured: â‘ the diameters of C5,C6,C7,C8,T1 cervical spine nerve roots and ventral nerve roots.â‘¡the lengths of ventral nerve roots.â‘¢the distances between the points where ventral roots penetrated the dura and the original sites of anterior and posterior division of each trunk, lateral cord, medial head of median nerve. â‘£the numbers of myelinated nerve fibers of ventral roots. Another 2 specimens were used to perform exploration of cervical spine by posterior approach and supraclavicular region by anterior approach. Sural nerve grafts bridged ventral root of C6 to the original site of anterior and posterior division of upper trunk. Results:The lengths of segment A of ventral roots became big in spine canal from C5 to T1 in spinal canal(P<0.01).They were: 11.4,12.8,14.1,16.3 and 20.1mm(Mean, as same as the followed ). In intervertebral foramen, C6 was thicker than the rest nerve roots(P<0.01). T1 was the thinnest(P<0.01). The diameters were 3.6 and 2.6mm separately. The diameters of all ventral roots were thin(1.5,1.6,1.6,1.5,1.2mm). The lengths of ventral roots of segment B became big from up to down also(P<0.01). They were: 11.0,11.8,12.5,13.1,13.9mm . Out of vertebral canal, the distances between the points where ventral roots penetrated the dura and the original sites of anterior and posterior division of each trunk of C6 was smallest(61.1mm,P<0.01).The distances between the points where ventral roots penetrated the dura and the original sites of anterior and posterior division of inferior trunk of C5, C6, C7(102.9,90.1,79.7mm), the distances between the points where ventral roots penetrated the dura and the original sites of lateral cord of them(103.1,90.1,81.3mm )became small both(P<0.01). The distances between the points where ventral roots penetrated the dura and median nerve of C5, C6, C7 became small(P<0.01). They were: 133.9,123.4,114.3mm. The myelinated nerve fiber of C7 was the most(6732,P<0.01). The fiber of T1 was the least(3896,P<0.01). The ventral root of C5 could be exposed clearly by posterior approach of cervical spine. The procedure of nerve transfer was feasible. Conclusion:1 The superiority of the procedure for repair of injuries of brachial plexus by remnant ventral root in spinal canal is verified by autopsy. 2 Modeling operation shows this new surgical procedure is practicable and feasible.