Analysis of the clinical effects of the transvertebral anterior approach for contralateral C7 nerve translocation in treating central upper limb paralysis: a retrospective study.

To investigate the clinical efficacy of the transvertebral anterior approach to contralateral C7 nerve translocation for treating patients with upper limb spastic hemiparesis caused by central nerve injury. Clinical data from 30 patients with central upper limb spastic hemiplegia were included in the study. All patients underwent rehabilitation exercises for an average of 21.00 (27.00) months before surgery. As no significant improvement in motor function or muscle tone of the paralyzed upper limb was observed, contralateral C7 nerve translocation was performed. Changes in motor function of the paralyzed upper limb were assessed using the Fugl-Meyer Motor Function Assessment Scale (FMA) and Brunnstrom Staging Scale (BSS). In contrast, changes in muscle tone were evaluated using the Modified Ashworth Spasticity Rating Scale (MAS). Generalized estimating equation (GEE) analysis was performed using the preoperative FMA, BSS, and MAS scores for the paralyzed upper limb as baseline values to assess improvements in motor function and muscle tone at 6 and 12 months postoperatively. Significant differences were observed in motor function (FMA score and BSS stage) and muscle tone (MAS score) of the paralyzed upper limb at 6 and 12 months post-surgery compared to baseline (P < 0.05) in 30 patients. Recovery of upper limb function and improvement in muscle tone following surgery were statistically significant. Recovery of the paralyzed upper limb showed a time-dependent cumulative effect, with greater improvement observed at 12 months post-surgery than at 6 months. Recovery of limb function exhibited progressive improvement from the proximal to the distal end. The FMA score for the shoulder and elbow region increased by 13.23 points (95% CI: 11.63-14.83, SE: 0.82) at 12 months postoperatively compared to baseline. The FMA score for the wrist and hand improved by 6.87 points (95% CI: 5.73-8.00, SE：0.58) at 12 months postoperatively compared to baseline; recovery of wrist and hand function was slower than that of the shoulder and elbow. Contralateral C7 nerve translocation helps improve central upper limb spastic paralysis and reduce muscle spasticity, thereby enhancing upper limb motor function.