Contralateral C7 Nerve Transfer for Spastic Hemiplegia: Upper Limb Recovery in a Retrospective Cohort Study

Upper-extremity motor function is a major concern in patients with spastic hemiplegia in active daily living.This retrospective cohort study aimed to evaluate alterations in upper extremity motor function following contralateral seventh cervical nerve transfer (CC7T) for spastic hemiplegia.This study included 19 patients with stroke.The cohort comprised 11 males (57%) and 8 females (43%), with seven subjects exhibiting right hemiplegia and 12 with left hemiplegia.Upper extremity motor function was assessed using the upper extremity Fugl-Meyer assessment (UE-FMA), box and block test, and modified Ashworth scale (MAS) before surgery, and at 8 weeks and 6 months after surgery.Post-CC7T surgery, there was a statistically significant increase in the total UE-FMA motor function score (P<0.001).Notably, improvement was observed in the upper extremity 6 months after surgery (P<0.001), with no significant differences in wrist, hand, or coordination/speed.Sensation, passive joint motion, and joint pain significantly improved postoperatively (P<0.017).However, the box and block test did not indicate a significant enhancement.The MAS scores demonstrated significant improvements in the elbow, wrist, fingers 2-5, and thumb between the preoperative and 8 weeks or 6 months after surgery (P<0.017).This study demonstrated that CC7T was effective in improving upper extremity function in stroke patients with spastic hemiplegia.Although the motor function improved only in the proximal part of the upper extremity, the decrease in spasticity of the upper extremity suggests that the distal part of the limb can be expected to improve later.