Surgical Technique of Xu's CC7 Procedure "Contralateral C7 to C7 Cross Nerve Transfer Through a Trans Longus Colli, Prespinal Route for Treating Spastic Arm".

ABSTRACT

BACKGROUND: The contralateral C7 transfer has been used for the treatment of brachial plexus root avulsion since 1986, and several modifications of this surgery have been described. Previous trial has verified the safety and effectiveness of the contralateral C7 to C7 cross nerve transfer for patients with longstanding spastic paralysis due to cerebral injuries, including stroke, traumatic brain injury, or cerebral palsy. However, the procedures for the surgery were not introduced in detail, with only rough descriptions. OBJECTIVE: To introduce and promote the Xu's CC7 procedure (contralateral C7 to C7 cross nerve transfer through a trans longus colli, prespinal route). METHODS: The renewed procedures were elaborated step by step, and the tips and tricks were clarified by case illustration in detail. Briefly, a modified trans longus colli, prespinal route was created, allowing the displaced C7 nerve to pass through the channel safely at the shortest distance. RESULTS: Tension-free anastomosis of the bilateral C7 nerves was achieved via the Xu's CC7 procedure with less surgical trauma while reducing the surgery time, postoperative recovery time, and nerve regeneration time. CONCLUSION: The Xu's CC7 procedure is a safer and more efficient technique for contralateral C7 to C7 cross nerve transfer. The detailed description in this article provides meaningful information for surgeons interested in the procedure.