Study Of Neural Cross Section Matching In Contralateral 7th Cervical Nerve Root Transfer To Low Trunk Through The Pre-vertebra Route

Objective:To explore each neural cross section matching in contralateral 7th cervical nerve root transfer through the pre-vertebra route and feasibility of median nerve lateral head repaired by ulnar nerve by studying and observing its neural cross section.Method:Seven adult antiseptic cadavers which had complete cervical part and upper limb (14 sides, three male six sides; four female eight sides; half in left and right) were selected in this experiment. All cadavers dissected according the exploratory approach of brachial plexus and revealed all brachial plexus from inter-vertebral foramen. 1 cm nerve tissue was cut and fixed from demarcated area of C7's trunks and strand; lower trunk's root and trunk; initiated area of median nerve lateral head and ulnar nerve. After all nerve tissues were fixed, dewatered gradiently, located embed, and made them into microtome section, then dyed them into HE microtome section and improvemental Palmgren's microtome section. The pictures were taken by a medicine figure imaging analysis system named MOTICMED 6.0. The area of nerves were measured under the pictures of 40 times amplifier; and the quantity of the nerve fiber were calculated under the pictures of 100, 200, 400 times amplifier, by Photoshop CS3 version image manipulation software using. All dates were analyzed by ANOVA and T-test of SPSS 13.0 statistical software. 0.05 was considered statistically signification.Results:In this experiment, seven cases fourteen sides nerve tissue were study. The average section area, average quantity of nerve fiber,quantity of nerve tract was 12.56±0.70mm2, 33954±2507, 8~11 in C7. It in lower trunk was 13.08±0.64mm2, 35322±3168, 9~13. It in lateral head of median nerve was 9.31±0.87mm2, 13101±1478,5~9. It in ulnar nerve was 8.71±0.97mm2, 12193±1758, 4~8. The average section area and average quantity of nerve fiber of all nerve was difference-less in gender and left or right limbs by statistical analysis.(P>0.05)In additional, the P value of C7 with lower trunk comparing and lateral head of median nerve with ulnar nerve comparing was large than 0.05 in the average section area and average quantity of nerve fiber. So, we considered that it was difference-less in the average section area and average quantity of nerve fiber of C7 with lower trunk comparing and lateral head of median nerve. Conclusion:In this study, we considered that the cross section matching of C7 with lower trunk comparing was reasonable than traditional operation technique. So, inosculating them together was feasible. In another hand, the cross section matching of lateral head of median nerve with ulnar nerve comparing was well. So, we could repair the lateral head of median nerve by ulnar nerve which was the branch of lower trunk. We could re-establish the finger flexor function of affected limb completely by this method.