{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T19:32:52Z","timestamp":1772307172978,"version":"3.50.1"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2009,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>In this study, the authors evaluated the efficacy of a new surgical strategy for reconnecting the injured brachial plexus with the spinal cord using fibrin glue containing acidic fibroblast growth factor as an adhesive and neurotrophic agent.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Eighteen patients with preganglionic brachial plexus injuries, each with varying degrees of upper limb dysfunction, underwent cervical laminectomy with or without sural nerve grafting. The treatment of each avulsed root varied according to the severity of the injury. Some patients also underwent a second-stage operation involving supraclavicular brachial plexus exploration for reconnection with the corresponding segment of cervical spinal cord at the trunk level. Muscle strength was graded both pre- and postoperatively with the British Medical Research Council scale, and the results were analyzed with the Friedman and Wilcoxon signed-rank tests.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Muscle strength improvements were observed in 16 of the 18 patients after 24 months of follow-up. Significant improvements in mean muscle strength were observed in patients from all repair method groups at 12 and 24 months postoperatively (p &lt; 0.05). Statistical significance was not reached in the groups with insufficient numbers of cases.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The authors' new surgical strategy yielded clinical improvement in muscle strength after preganglionic brachial plexus injury, such that nerve regeneration may have taken place. Reconnection of the brachial plexus to the cervical spinal cord is possible. Functional motor recovery, observed through increases in Medical Research Council\u2013rated muscle strength in the affected arm, is likewise possible.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2008.8.jns08328","type":"journal-article","created":{"date-parts":[[2009,1,2]],"date-time":"2009-01-02T16:05:27Z","timestamp":1230912327000},"page":"775-785","source":"Crossref","is-referenced-by-count":15,"title":["A novel strategy for repairing preganglionic cervical root avulsion in brachial plexus injury by sural nerve grafting"],"prefix":"10.3171","volume":"110","author":[{"given":"Jau-Ching","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Chao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-An","family":"Tsai","sequence":"additional","affiliation":[{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"Department of Physical Medicine and Rehabilitation, and"},{"name":"School of Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Chun","family":"Chen","sequence":"additional","affiliation":[{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"Department of Family Medicine, Taipei Veterans General Hospital, Taipei;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-Hsin","family":"Shih","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrich","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery,"},{"name":"Neural Regeneration Laboratory, Neurological Institute,"},{"name":"School of Medicine and"},{"name":"Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-08328","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1385","DOI":"10.1227\/01.NEU.0000065134.21334.D7","article-title":"Brachial plexus avulsion injury repairs with nerve transfers and nerve grafts directly implanted into the spinal cord yield partial recovery of shoulder and elbow movements","volume":"52","author":"Bertelli","year":"2003"},{"key":"b2-08328","series-title":"Microsurgery","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1002\/micr.20234","article-title":"Concepts of nerve regeneration and repair applied to brachial plexus reconstruction","volume":"26","author":"Bertelli","year":"2006"},{"key":"b3-08328","series-title":"Microsurgery","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1002\/micr.1920160106","article-title":"Spinal nerve root injuries in brachial plexus lesions: basic science and clinical application of new surgical strategies. 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