Parálisis obstétrica del plexo braquial: resultados preliminares de la transferencia del nervio espinal accesorio al nervio supraescapular en 10 casos

• Autores: Sebastian Valbuena
• Localización: Revista de la Asociación Argentina de Ortopedia y Traumatología, ISSN 1852-7434, Vol. 80, Nº. 2, 2015, págs. 113-120
• Idioma: español
• DOI: 10.15417/295
• Títulos paralelos:
  • Accessory nerve to suprascapular nerve transfer in obstetrical brachial plexus palsy: preliminary results in 10 cases
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Objetivovaluar los resultados preliminares sobre 10 casos de transferencias del nervio espinalaccesorio (NEA) al nervio supraescapular (NS) en parálisis obstétricas delplexo braquial (POPB).Material y métodosEntre los años 2010 y 2012 se realizaron 16 transferencias del NEA al NS en POPB. Fueron incluidos 10 casos que presentabanseguimiento mínimo de 18 meses. Se evaluó valores de fuerza muscular del hombrosegún la escala de Gilbert y se  usaronescalas funcionales de Mallet, y de Gilbert. Se comparó valores pre-operatoriosy post-operatorios, así como las diferencias entre parálisis de tipo parcial ytotal. Se utilizó el test de Student para valorar la significancia estadísticade los datos.ResultadosElseguimiento promedio fue de 20,9 meses. Se encontró valores mediospreoperatorios de fuerza de abducción de 0,48 M, y postoperatorios de 2,70 M,los valores de RE preoperatorios fueron de 0 M, y al final del seguimiento de2,4 M. Todos los pacientes mostraban patrones preoperatorios tipo 1 tanto de laescala de Mallet como la de Gilbert, con valores postoperatorios promedios de3,2 y 3,5 respectivamente. Diferencias estadísticas significativas seencontraron entre estos valores.ConclusiónSi bien esta serie presenta valores preliminares con un seguimiento corto, y suprincipal crítica es el bajo número de casos. Los resultados funcionales obtenidos coinciden con otros reportes, y avalan el uso de la misma en las reconstrucciones del plexo braquial que requieran aporte extra-plexual.

  • English

    BackgroundTo evaluate the preliminary results of spinal accessory nerve to suprascapular nerve transfer in obstetric brachial plexus palsy.MethodsBetween 2010 and 2012, 16 transfers of spinal accessory nerve to suprascapular nerve were performed in obstetric brachial plexus palsy. Ten patients with a minimum follow-up of 18 months were included. Values of muscle power were assessed according to the Gilbert scale, and functional scales of the shoulder (Mallet and Gilbert) were used. Preoperative and postoperative values, and the differences between partial and total paralysis results were compared. Student test was used for the statistical analysis.ResultsThe average follow-up was 20.9 months. Preoperative shoulder abduction power was 0.48 M, preoperative external rotation power was 0 M, and those values at the end of the follow-up were 2.70 M and 2.4 M, respectively. All patients had type 1 patterns of the Gilbert and Mallet scales, with mean postoperative values of 3.2 and 3.5, respectively. Statistically significant differences were found between these values.ConclusionsLimitations of this preliminary report are the short follow-up and the low number of cases. However, the functional results obtained are consistent with those from other reports, and they support the use of the spinal accessory neve to suprascapular nerve transfer in brachial plexus reconstructions requiring an extra-plexual contribution.

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