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Figure 4 | Journal of Brachial Plexus and Peripheral Nerve Injury

Figure 4

From: Direct cord implantation in brachial plexus avulsions: revised technique using a single stage combined anterior (first) posterior (second) approach and end-to-side side-to-side grafting neurorrhaphy

Figure 4

A posterior cervical laminectomy, while the patient is in the lateral position; the right shoulder is in the upper right corner; the head is on the left. The dura has been incised. The grafts have been passed through the dural incision and placed in an end(graft)-to-side(cord) and side(graft)-to-side(cord) fashion for about 4 cms along the anterior cord close to the midline sulcus in a subpial plane. They are held in place by placing them anterior to C4 intradural cervical nerve root proximally and T1 intradural nerve root distally. In 5 minutes, they adhere to the cord. The dura is closed using 3/0 prolene continuous sutures. The inset shows the position of the patient.

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Journal of Brachial Plexus and Peripheral Nerve Injury

ISSN: 1749-7221