Evidence map›Paper›PMID 37729631›Full record

ArticleOperative neurosurgery (Hagerstown, Md.)2023

Axillary to Radial Nerve Transfer for Recovery of Elbow Extension After Spinal Cord Injury.

Stanley Bazarek, Jasmine A Thum, Margaret Sten, Grace Magee, Ross Mandeville, Justin M Brown

Abstract read
In one paragraph

Article in Operative neurosurgery (Hagerstown, Md.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Stanley BazarekDepartment of Neurosurgery, Harvard Medical School, Brigham & Women's Hospital, Boston , Massachusetts , USA.
Jasmine A ThumDepartment of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston , Massachusetts , USA.ORCID 0000-0003-4137-2137
Margaret StenDepartment of Neurosurgery, Harvard Medical School, Brigham & Women's Hospital, Boston , Massachusetts , USA.
Grace MageeDepartment of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston , Massachusetts , USA.
Ross MandevilleDepartment of Neurology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA.
Justin M BrownDepartment of Neurosurgery, Harvard Medical School, Massachusetts General Hospital, Boston , Massachusetts , USA.ORCID 0000-0002-1853-1278

Funding

Neuroscience Resident Research ProgramR25NS065743 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S, WILLIAMS, ZIV · 2009 to 2023
$11.8M
Neuroscience Resident Research ProgramUE5NS065743 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI SYDNEY S CASH, Ziv Williams · 2024 to 2026
$2.6M
NIH HHS 5R25NS065743-14NINDS NIH HHS R25 NS065743NINDS NIH HHS UE5 NS065743
6 · The paper itself

Abstract

BACKGROUND AND

objectivesCervical spinal cord injuries (SCI) result in severe loss of function and independence. Nerve transfers have become a powerful method for restoring upper extremity function, the most critical missing function desired by this patient population. Recovery of active elbow extension allows for expansion of one's workspace to reach for objects and stabilizes control at the elbow joint. Without triceps function, a patient with a cervical SCI is rendered entirely helpless when in the supine position. Our objective was to provide a concise description of the transfer of branches of the axillary nerve (AN) to the long head of the triceps branch of the radial nerve (RN) for restoration of elbow extension after cervical SCI.

methodsAn anterior, axillary approach is used for the transfer of the nerve branches of the AN (which may include branches to the teres minor, posterior deltoid, or even middle deltoid) to the long head of the triceps branch of the RN. Preoperative assessment and intraoperative stimulation are demonstrated to direct optimal selection of axillary branch donors.

resultsThe axillary approach provides full access to all branches of the AN in optimal proximity to triceps branches of the RN and allows for tension-free coaptation to achieve successful recovery of elbow extension. Final outcomes may not be achieved for 18 months. Of our last 20 patients with greater than 12-month follow-up, 13 have achieved antigravity strength in elbow extension, 4 are demonstrating ongoing progression, and 3 are definitive failures by 18 months.

conclusionThe axillary to RN transfer is an important intervention for recovery of elbow extension after cervical SCI, which significantly improves quality of life in this patient population. Further large population outcomes studies are necessary to further establish efficacy and increase awareness of these procedures.

Indexed as

Elbow JointNerve TransferSpinal Cord InjuriesElbowHumansQuality of LifeRadial Nerve

Identifiers

PMID37729631
PMCPMC12245348

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.