Surgical Technique: Spinal Accessory to Infraspinatus Nerve Transfer in Brachial Plexus Birth Injury

Heather R Burns; Tanir A Moreno; Alexandra L McLennan; Erica Y Xue; Jenny Lee Nguyen; Brinkley K Moore

doi:10.1097/BTH.0000000000000493

Surgical Technique: Spinal Accessory to Infraspinatus Nerve Transfer in Brachial Plexus Birth Injury

Tech Hand Up Extrem Surg. 2024 Sep 13. doi: 10.1097/BTH.0000000000000493. Online ahead of print.

Authors

Heather R Burns^{1

2}, Tanir A Moreno^{1

2}, Alexandra L McLennan^{1

2}, Erica Y Xue^{1

2}, Jenny Lee Nguyen^{1

2}, Brinkley K Moore^{1

2}

Affiliations

¹ Michael E. DeBakey Division of Plastic Surgery, Department of Surgery, Baylor College of Medicine.
² Division of Plastic Surgery, Department of Surgery, Texas Children's Hospital, Houston, TX.

PMID: 39267453
DOI: 10.1097/BTH.0000000000000493

Abstract

Nerve transfers, nerve grafts, and tendon transfers have been used to restore shoulder active external rotation in patients with brachial plexus birth injuries. Traditionally used nerve surgery techniques are nerve transfer from the spinal accessory nerve to a suprascapular nerve (SSN) or nerve grafting from C5 to the SSN. However, results are often suboptimal. A more distal and more targeted transfer from the spinal accessory nerve directly to the infraspinatus branch of the SSN has previously been described and mid-term outcomes are encouraging. Herein, we describe a modification of this technique with accompanying step-by-step intraoperative photographs.