SELECTIVE RESTORATION OF SENSATION BY PERIPHERAL-NERVE GRAFTS DIRECTLY IMPLANTED INTO THE CONTRALATERAL C7 DORSAL-ROOT GANGLION - AN EXPERIMENTAL-STUDY IN RAT BRACHIAL-PLEXUS

OBJECTIVE: In brachial plexus injuries, when the dorsal root ganglion (DRG) is avulsed from the spinal cord there is no possibility of direc t repair. Therefore, in the present report the median nerve was connec ted directly to the contralateral C7 DRG, to restore forepaw sensation . METHODS: The ulnar nerve was sectioned, and a 15-mm segment of nerve was removed. The median nerve was sectioned, transposed dorsally, and repaired using a sural nerve graft directly implanted into the C7 con tralateral DRG. Rats were then assessed 6 and 12 months later by behav ioral, histological, and plasma extravasion techniques. RESULTS: All a nimals recovered sensation in the forepaw. Retrogradely labeled sensor y neurons were demonstrated in the C7 DRG, and the whole forepaw was l abeled after plasma extravasion induction by median nerve antidromic s timulation. Several myelinated and positively neurofilament-stained fi bers were demonstrated in the grafted median nerve. CONCLUSION: The su rgical strategy proposed might be a useful alternative to selective se nsory repair in the emerging field of brachial plexus reconstruction b y direct spinal cord surgery.