{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:23:17Z","timestamp":1770351797776,"version":"3.49.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"24","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Nerve transfer is a surgical technique in which a redundant or expendable fascicle is transferred or coapted to an injured nerve distal to the site of injury for the purpose of reinnervation. Successful nerve transfer is dependent on correct intraoperative identification of donor and recipient nerves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>An 8-year-old male was recommended for ulnar nerve fascicle to biceps branch of musculocutaneous nerve transfer to restore elbow flexion weakness after a demyelinating spinal cord injury. The biceps branch was identified approximately midway along the upper arm. Proximal musculocutaneous nerve stimulation induced hand movement and electromyography activity in the median nerve muscles. Neurolysis of the thickened proximal structure revealed fusion of the musculocutaneous and median nerves. Because of the proximity of the median and musculocutaneous nerves, median rather than ulnar nerve fascicles were used as donors for transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The authors provide the first reported intraoperative finding of an anatomical variant in which the musculocutaneous nerve and median nerve were fused in the upper arm, confirmed through intraoperative electrical stimulation. Surgeons should be aware of this rare anatomical variant to ensure correct nerve identification when performing nerve transfers in the proximal upper extremity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23469","type":"journal-article","created":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T19:30:32Z","timestamp":1702323032000},"source":"Crossref","is-referenced-by-count":1,"title":["Rare median and musculocutaneous nerve fusion with intraoperative electrical confirmation: illustrative case"],"prefix":"10.3171","volume":"6","author":[{"given":"Audrey","family":"Huang","sequence":"first","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Vazquez","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Dominguez","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York;"},{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avinash","family":"Mohan","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York;"},{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Li","sequence":"additional","affiliation":[{"name":"Neurology, Westchester Medical Center, Valhalla, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared M","family":"Pisapia","sequence":"additional","affiliation":[{"name":"School of Medicine, New York Medical College, Valhalla, New York;"},{"name":"Departments of Neurosurgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurotherapeutics","first-page":"26","article-title":"Novel uses of nerve transfers","volume":"16","author":"Wilson TJ","year":"2019","unstructured":"Wilson TJ. Novel uses of nerve transfers. Neurotherapeutics. 2019;16(1):26\u201335."},{"issue":"3","key":"b2","series-title":"J Hand Surg Am","first-page":"200","article-title":"Nerve transfers in the upper extremity","volume":"4","author":"Weber RV","year":"2004","unstructured":"Weber RV, MacKinnon SE. Nerve transfers in the upper extremity. J Hand Surg Am. 2004;4(3):200\u2013213."},{"issue":"2","key":"b3","series-title":"J Hand Surg Am","first-page":"332","article-title":"Nerve transfers: indications, techniques, and outcomes","volume":"35","author":"Tung TH","year":"2010","unstructured":"Tung TH, Mackinnon SE. Nerve transfers: indications, techniques, and outcomes. J Hand Surg Am. 2010;35(2):332\u2013341."},{"issue":"2","key":"b4","series-title":"J Hand Surg Am","first-page":"232","article-title":"Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases","volume":"19","author":"Oberlin C","year":"1994","unstructured":"Oberlin C, B\u00e9al D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994;19(2):232\u2013237."},{"issue":"3","key":"b5","series-title":"Plast Reconstr Surg","first-page":"915","article-title":"Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies","volume":"117","author":"Liverneaux PA","year":"2006","unstructured":"Liverneaux PA, Diaz LC, Beaulieu JY, Durand S, Oberlin C. Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plast Reconstr Surg. 2006;117(3):915\u2013919."},{"issue":"5","key":"b6","series-title":"Clin Anat","first-page":"327","article-title":"Classification of communications between the musculocutaneous and median nerves","volume":"11","author":"Venieratos D","year":"1998","unstructured":"Venieratos D, Anagnostopoulou S. Classification of communications between the musculocutaneous and median nerves. Clin Anat. 1998;11(5):327\u2013331."},{"issue":"1","key":"b7","series-title":"Clin Anat","first-page":"11","article-title":"Patterns of connections between the musculocutaneous and median nerves in the axilla and arm","volume":"15","author":"Choi D","year":"2002","unstructured":"Choi D, Rodr\u00edguez-Niedenf\u00fchr M, V\u00e1zquez T, Parkin I, Sa\u00f1udo JR. Patterns of connections between the musculocutaneous and median nerves in the axilla and arm. Clin Anat. 2002;15(1):11\u201317."},{"issue":"3","key":"b8","series-title":"Folia Med Cracov","first-page":"45","article-title":"Fusion between the median and musculocutaneous nerve: a case study","volume":"59","author":"Clarke E","year":"2019","unstructured":"Clarke E, Wysiadecki G, Ha\u0142adaj R, Skrzat J. Fusion between the median and musculocutaneous nerve: a case study. Folia Med Cracov. 2019;59(3):45\u201352."},{"issue":"3","key":"b9","series-title":"Rev Bras Ortop","first-page":"366","article-title":"Rare anatomical variation of the musculocutaneous nerve\u2014case report","volume":"51","author":"Nascimento SRR","year":"2016","unstructured":"Nascimento SRR, Ruiz CR, Pereira E, Andrades L, de Souza CC. Rare anatomical variation of the musculocutaneous nerve\u2014case report. Rev Bras Ortop. 2016;51(3):366\u2013369."},{"key":"b10","series-title":"Transl Res Anat","first-page":"100092","article-title":"The absent musculocutaneous nerve: a systematic review","volume":"22","author":"Hunter DD","year":"2021","unstructured":"Hunter DD, Zdilla MJ. The absent musculocutaneous nerve: a systematic review. Transl Res Anat. 2021;22:100092."},{"issue":"9","key":"b11","series-title":"J Clin Diagn Res","first-page":"AD06","article-title":"Bilateral absence of musculocutaneous nerve: a case report","volume":"8","author":"Sarkar A","year":"2014","unstructured":"Sarkar A, Saha A. Bilateral absence of musculocutaneous nerve: a case report. J Clin Diagn Res. 2014;8(9):AD06\u2013AD07."},{"issue":"6","key":"b12","series-title":"Anesth Analg","first-page":"1729","article-title":"Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study","volume":"110","author":"Remerand F","year":"2010","unstructured":"Remerand F, Laulan J, Couvret C,  Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study. Anesth Analg. 2010;110(6):1729\u20131734."},{"issue":"2","key":"b13","series-title":"Radiol Med (Torino)","first-page":"135","article-title":"Ultrasound-guided anterior axilla musculocutaneous nerve block","volume":"119","author":"Kokkalis ZT","year":"2014","unstructured":"Kokkalis ZT, Mavrogenis AF, Saranteas T, Stavropoulos NA, Anagnostopoulou S. Ultrasound-guided anterior axilla musculocutaneous nerve block. Radiol Med (Torino). 2014;119(2):135\u2013141."},{"issue":"5","key":"b14","series-title":"Rev Bras Ortop","first-page":"567","article-title":"Communication between the musculocutaneous and median nerves in the arm: an anatomical study and clinical implications","volume":"50","author":"Ballesteros LE","year":"2014","unstructured":"Ballesteros LE, Forero PL, Buitrago ER. Communication between the musculocutaneous and median nerves in the arm: an anatomical study and clinical implications. Rev Bras Ortop. 2014;50(5):567\u2013572."},{"issue":"1","key":"b15","series-title":"Am J Anat","first-page":"143","article-title":"Comparative studies upon the morphology and distribution of the brachial plexus","volume":"54","author":"Miller RA","year":"1934","unstructured":"Miller RA. Comparative studies upon the morphology and distribution of the brachial plexus. Am J Anat. 1934;54(1):143\u2013175."},{"issue":"1","key":"b1","series-title":"Neurotherapeutics","first-page":"26","article-title":"Novel uses of nerve transfers","volume":"16","author":"Wilson TJ","year":"2019","unstructured":"Wilson TJ. Novel uses of nerve transfers. Neurotherapeutics. 2019;16(1):26\u201335."},{"issue":"3","key":"b2","series-title":"J Hand Surg Am","first-page":"200","article-title":"Nerve transfers in the upper extremity","volume":"4","author":"Weber RV","year":"2004","unstructured":"Weber RV, MacKinnon SE. Nerve transfers in the upper extremity. J Hand Surg Am. 2004;4(3):200\u2013213."},{"issue":"2","key":"b3","series-title":"J Hand Surg Am","first-page":"332","article-title":"Nerve transfers: indications, techniques, and outcomes","volume":"35","author":"Tung TH","year":"2010","unstructured":"Tung TH, Mackinnon SE. Nerve transfers: indications, techniques, and outcomes. J Hand Surg Am. 2010;35(2):332\u2013341."},{"issue":"2","key":"b4","series-title":"J Hand Surg Am","first-page":"232","article-title":"Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases","volume":"19","author":"Oberlin C","year":"1994","unstructured":"Oberlin C, B\u00e9al D, Leechavengvongs S, Salon A, Dauge MC, Sarcy JJ. Nerve transfer to biceps muscle using a part of ulnar nerve for C5-C6 avulsion of the brachial plexus: anatomical study and report of four cases. J Hand Surg Am. 1994;19(2):232\u2013237."},{"issue":"3","key":"b5","series-title":"Plast Reconstr Surg","first-page":"915","article-title":"Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies","volume":"117","author":"Liverneaux PA","year":"2006","unstructured":"Liverneaux PA, Diaz LC, Beaulieu JY, Durand S, Oberlin C. Preliminary results of double nerve transfer to restore elbow flexion in upper type brachial plexus palsies. Plast Reconstr Surg. 2006;117(3):915\u2013919."},{"issue":"5","key":"b6","series-title":"Clin Anat","first-page":"327","article-title":"Classification of communications between the musculocutaneous and median nerves","volume":"11","author":"Venieratos D","year":"1998","unstructured":"Venieratos D, Anagnostopoulou S. Classification of communications between the musculocutaneous and median nerves. Clin Anat. 1998;11(5):327\u2013331."},{"issue":"1","key":"b7","series-title":"Clin Anat","first-page":"11","article-title":"Patterns of connections between the musculocutaneous and median nerves in the axilla and arm","volume":"15","author":"Choi D","year":"2002","unstructured":"Choi D, Rodr\u00edguez-Niedenf\u00fchr M, V\u00e1zquez T, Parkin I, Sa\u00f1udo JR. Patterns of connections between the musculocutaneous and median nerves in the axilla and arm. Clin Anat. 2002;15(1):11\u201317."},{"issue":"3","key":"b8","series-title":"Folia Med Cracov","first-page":"45","article-title":"Fusion between the median and musculocutaneous nerve: a case study","volume":"59","author":"Clarke E","year":"2019","unstructured":"Clarke E, Wysiadecki G, Ha\u0142adaj R, Skrzat J. Fusion between the median and musculocutaneous nerve: a case study. Folia Med Cracov. 2019;59(3):45\u201352."},{"issue":"3","key":"b9","series-title":"Rev Bras Ortop","first-page":"366","article-title":"Rare anatomical variation of the musculocutaneous nerve\u2014case report","volume":"51","author":"Nascimento SRR","year":"2016","unstructured":"Nascimento SRR, Ruiz CR, Pereira E, Andrades L, de Souza CC. Rare anatomical variation of the musculocutaneous nerve\u2014case report. Rev Bras Ortop. 2016;51(3):366\u2013369."},{"key":"b10","series-title":"Transl Res Anat","first-page":"100092","article-title":"The absent musculocutaneous nerve: a systematic review","volume":"22","author":"Hunter DD","year":"2021","unstructured":"Hunter DD, Zdilla MJ. The absent musculocutaneous nerve: a systematic review. Transl Res Anat. 2021;22:100092."},{"issue":"9","key":"b11","series-title":"J Clin Diagn Res","first-page":"AD06","article-title":"Bilateral absence of musculocutaneous nerve: a case report","volume":"8","author":"Sarkar A","year":"2014","unstructured":"Sarkar A, Saha A. Bilateral absence of musculocutaneous nerve: a case report. J Clin Diagn Res. 2014;8(9):AD06\u2013AD07."},{"issue":"6","key":"b12","series-title":"Anesth Analg","first-page":"1729","article-title":"Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study","volume":"110","author":"Remerand F","year":"2010","unstructured":"Remerand F, Laulan J, Couvret C,  Is the musculocutaneous nerve really in the coracobrachialis muscle when performing an axillary block? An ultrasound study. Anesth Analg. 2010;110(6):1729\u20131734."},{"issue":"2","key":"b13","series-title":"Radiol Med (Torino)","first-page":"135","article-title":"Ultrasound-guided anterior axilla musculocutaneous nerve block","volume":"119","author":"Kokkalis ZT","year":"2014","unstructured":"Kokkalis ZT, Mavrogenis AF, Saranteas T, Stavropoulos NA, Anagnostopoulou S. Ultrasound-guided anterior axilla musculocutaneous nerve block. Radiol Med (Torino). 2014;119(2):135\u2013141."},{"issue":"5","key":"b14","series-title":"Rev Bras Ortop","first-page":"567","article-title":"Communication between the musculocutaneous and median nerves in the arm: an anatomical study and clinical implications","volume":"50","author":"Ballesteros LE","year":"2014","unstructured":"Ballesteros LE, Forero PL, Buitrago ER. Communication between the musculocutaneous and median nerves in the arm: an anatomical study and clinical implications. Rev Bras Ortop. 2014;50(5):567\u2013572."},{"issue":"1","key":"b15","series-title":"Am J Anat","first-page":"143","article-title":"Comparative studies upon the morphology and distribution of the brachial plexus","volume":"54","author":"Miller RA","year":"1934","unstructured":"Miller RA. Comparative studies upon the morphology and distribution of the brachial plexus. Am J Anat. 1934;54(1):143\u2013175."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/24\/article-CASE23469.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/24\/article-CASE23469.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/6\/24\/article-CASE23469.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T14:36:44Z","timestamp":1770302204000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/6\/24\/article-CASE23469.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,11]]},"references-count":30,"journal-issue":{"issue":"24"},"URL":"https:\/\/doi.org\/10.3171\/case23469","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,11]]}}}