United Brachial Plexus Network, Inc.

Has anyone ever had reconstruction of BPI using "intercostals and contralateral C-7?" The Mayo Clinic suggested that for me possibly. I'm not sure what that is. Does anyone? My left arm is paralyzed from motorcycle accident on 6/10/05. Dr. Spinner at the Mayo Clinic wrote me a reply when I wrote to him to ask him what could be done for me. If anyone has had similar procedures I would love to hear from you. Thanks. Frank

Hey Frank,
I'm looking at surgery options, too. My left arm is also paralyzed although I have most of the use of my hand. Believe it or not, my car accident was the same day as your motorcycle accident. My physical therapist suggested a group in California--SanDiego I think. I'll post anything I find out.
Starla

Hi Frank,
I'm sure others will respond, but here's my understanding of what you asked. I believe you said you avulsed all 5 nerves, so the surgeons will need to get useable nerves for grafting or xfering from other areas of your body, ie intercostals (nerves that run between your ribs), surals from behind your legs, axillary, etc. Some surgeons use the intercostals to restore sensation to the affected arm - they'll seperate the intercostals and re-route them to your arm in hopes of innervating the muscles. Once the muscles are innervated, and you touch or rub that area of your arm, you'll be able to feel it in your rib area where the nerves originated. I believe it's a "preservation" method to prevent injury to your arm. The contraleral C7 is where they take the intact C7 from your "good" side and split it to innervate the affected side. I'm not sure, but I believe it will make the affected arm do the opposite of what the functioning arm will do-so if you curl your functioning arm, your affected arm will straighten and if you straighten your functioning arm, your affected arm will raise it. It takes a little re-training, but I suppose anyone with BPI will have to do some amount of re-training. For those of you with better knowledge on these procedures, forgive me if I've fumbled it up. Hope it helps.
Lourdes

Starla,

If you want to get in contact with a good Brachial Plexus surgeon, I reccomend that you visit Dr. Edgerton and Dr. Kazmiroff in the Kaiser Permanente in West Los Angeles. They performed many operations on me which led me to have much more mobilit in my arm than I could ever have hoped for.

And for the topic. I believe the intercostal nerves are the nerves located inside your rib cage. I was having the surgery done to repair my triceps, but they stopped in the middle of it when they saw that my triceps were still alive, but very weak. It was too late for my broken rib cages though. From what I understand they take the nerves from your rib cages that are used for sensitivity around the breast. I lost some feeling in my upper left torso area, but it has almost come back to normal sensation - not that it mattered for me anyway because I am a guy. Anyways, the nerves from the rib cage gets connected to the muscle that needs to be revived. It was tricky surgery, but I felt very confident with my doctor.

Hi Frank,

My son went to Mayo and the team did all the procedures you mentioned. I think the best way for you to understand what's being proposed is for you to read an article that Mayo published last fall in a hand surgery journal. I have a copy of it as a pdf file & can email it to you if you'd like.

Then after you read it I'll be glad to answer any questions you still have.

I don't think you can do better than Mayo, so I hope you'll continue to consider them.

Take care,

Ellen

PS - the surgery went very well, all target muscles are innervated, all donor sites are fine - and the surgery was filmed & shown on Discovery Health Channel if you want to see it on DVD.

Ellen,
Yes, Please send me the information. The more informed I am, the better I can understand the doctors. My address is simonett46@yahoo.com
Thanks.
Frank

Frank, I had intercostal nerve grafts 13 years ago, and they were very successful. I can bend my arm because the bicep was re-innervated using this procedure. I have to admit tho, that it isn't of any real practical use to me, probably because I don't actually use it for anything practical..if you see what I mean!

I haven't had the contra-C7 surgery, but I do know one or two people who have, and they post sometimes on the UK messageboards. I don't think they've ever posted here...

When you question the Drs., ask them to be completely honest about your prospects, and the length of time it will take for you to see any benefit from this surgery. It's no walk in the park by all accounts. I know one or two prominent surgeons who are not happy with the trade off between the length of time of the recovery period, the physical therapy involved and the amount of re-innervation that is possible.

Best of luck with your decision...don't forget, ask EVERYTHING again and again.

All the best

Lizzy F

Hi Frank.

Do you plan to see Dr. Spinner at Mayo? I was referred to him by my doc and am wondering if you know anything about him. My problem is related to nerves in my foot.

Did you send him an email directly from the Mayo site?

Thanks.

Dee,
I just wrote Spinner a letter explaining my case. And he replied by letter. I have an appointment for March 9th.
Frank

My son had three nerver transfers done by the doctors at Mayo Clinic. They are wonderful and I would recommend them to anyone. My son's accident was on 6/11/05. He had his surgery done on 10/11/05 and is actually getting some movement back in his arm. Go for it!