Who here has had success post avulsion, after surgery?

Treatments, Rehabilitation, and Recovery
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Re: Who here has had success post avulsion, after surgery?

Post by Mica » Mon Sep 20, 2010 7:53 pm


Our daughter is OBPI, not TBPI - but she had two transfers (in addition to a boatload of grafts). She had C6 (avulsed) transferred into C5, which was moderately successful. However, transferring her suprascapular nerve into her spinal accessory nerve was wildly successful. It sucks that it wiped out her middle and lower trap fibers, but she got external rotation for the trade.

I've spoken with people who saw results from their transfers quite soon. For Aria, it took us about a year to really see improvement.

Hope that helps. I wish you a great recovery!!!



Re: Who here has had success post avulsion, after surgery?

Post by shaunnb » Tue Sep 21, 2010 12:19 am


26th may 2008, i had a motorcycle accident due to a Subarachnoid hemorrhage.

my C5 & C6 were affected. This primarily caused loss of bicep/brachiallis, and deltoid in my left arm.

initially i had a nerve graft using the sural nerve from my left leg, within 3 months from my accident. then followed a further two surgeries. my surgeon though with the second, he used a Fascicle of a nerve which was not strong enough. i then had another nerve transfer, using Fascicles of my ulnar and median nerves. the last of my surgeries was 22 months ago.

im really cant remember when i felt that first flicker in my bicep.. but remember how happy i was when it occurred.

so far i have recovered my bicep and brachiallis very well.. the deltoid is slowly getting there..

good luck with your recovery & god bless..


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Posts: 845
Joined: Wed Jun 18, 2003 10:09 pm
Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02

Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed

BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.

Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)

"Do what you can, with what you have, where you are."
~Theodore Roosevelt
Location: Los Angeles, California USA

Re: Who here has had success post avulsion, after surgery?

Post by Christopher » Tue Sep 21, 2010 4:47 am

I avulsed C5,C6, & C7. All my surgeries where successful on my right arm injury. My accessory nerve & right phrenic nerve where shot due to injury, so they weren't available for transfers.

I had a free gracilus muscle transfer to right arm bicep region which was innervated with 2 intercostal nerves, and 2 more intercostals innervating the actual bicep as well. Half of my left side C7 transferred to right deltoids (and sural nerve grafts from both calves to supplement distance of transfer for both C7 & intercostal transfers). These surgeries where done at 4 months to the day of injury. Also had fascicles from my ulnar nerve transferred to the long head triceps at 9 months post injury (this was a surgery I came up with after interviewing with so many surgeons and was a world first as far as I know).

Intercostal transfers took about 9 months before flickers started to show in my muscles. The hemi-C7 transfer took about 15 months, and the unlar transfer took about 8-9 months before evidence appeared to be successful.

I personally was expecting a lot more functional return than I got, but I was being unrealistic and expecting to "get my arm back". I can lift about 5 lbs with my bicep up just below my chin (I have limited hand function). The Hemi-C7 to deltoids is more or less keeping my shoulder from subluxing and arm from falling out of socket. It doesn't have muck more function beyond that.

I also had tendon transfers for better hand function (wrist flexor to 3 finger extensors; middle, ring, & pinky)

The waiting game is lethal, at least it was for me. It felt extremely demoralizing to constantly be focusing on my paralyzed arm and trying to get its muscles to fire with electrical stimulation and see no results week after week, month after month. All I can say, is keep your eye on the prize and find gratitude where ever you can and focus on that. You may not be having any trouble with this, but Io sure as hell did.

Wishing you as the best recovery and as possible!


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Posts: 82
Joined: Fri Dec 11, 2009 11:50 am
Injury Description, Date, extent, surgical intervention etc: May 24, 2008 an 88 year old lady did not see me and pulled out while I was riding my 06 HD Street Glide. The accident resulted in 9 broken bones and brain hemorrhaging. The accident's most serious results was two avulsions confirmed in my C6 & C7 vertebrae. In Oct of 08 Dr. Li of Wake Forest University performed nerve transfer lasting around 8 hours in surgery. I have limited use now of my left arm. It took until July of 09 before it moved at all, and now is moving limited. I experience burning pain in my left hand, staying busy helps keep the mind off of burning. I visited the Mayo Clinic May, 2010 and consulted with their brachial plexus team. May 1, 2012, I underwent a muscle transfer at Wake Forest University. This surgery was deemed a success and I have more movement in my arm.
Location: Fuquay Varina NC 27526

Re: Who here has had success post avulsion, after surgery?

Post by hilltopfwb » Wed Sep 29, 2010 12:18 pm

I had my surgery 5 months after my accident. I had nerve transfers for my shoulder and for my bicep and my deltoid muscles. It took 9 months for my arm to begin to stay in socket and for my bicep to work at all. I can lift around 3 pounds chest level today and my arm doesn't experience the subluxation (sp?) that it did for the first year of paralysis to my arm. I think 2 things have happened in my mind. I have lowered my expectations from "getting my arm back" to a more realistic expectation, "having use of my hand and arm". I can open doors and such, but it is obviously very limited. I had my surgery done at Wake Forest Univerisity by Dr. Li. I have also gone to Mayo for a consult. Insurance covered Dr. Li who did an excellent job.

Posts: 23
Joined: Fri Jul 16, 2010 12:15 pm

Re: Who here has had success post avulsion, after surgery?

Post by gimpyfireman2010 » Fri Oct 01, 2010 6:06 pm

Some good news here.

Keep up the positive posts guys! It really helps those of us in the early stages post surgery.

Posts: 21
Joined: Tue Dec 08, 2009 1:44 pm
Injury Description, Date, extent, surgical intervention etc: Full root avulsion of C5,C6,C7,C8,T1 September 2009.
Surgery October 2009.
Donor nerve taken from fore arm, sliced into 3 pieces.
Used for C5, C6 , C7 to re implanted back into the spine and attached
to brachial.
Location: Ireland

Re: Who here has had success post avulsion, after surgery?

Post by pieface » Wed Nov 03, 2010 8:14 pm

i had full root evulsion of C5-C6-C7-C8-T1, i had C5-C6-C7 re-implanted using donor nerve from my effected arm, accident september 2009, operation october 2009, at first no movement, but now i can move my arm out and to the side, rougly door handle height, only a slight bend in the elbow possible at moment, i can also (rotate) my hand/wrist a small bit too.

In swimming pool i have good range of movement and can bend my elbow, do when i bend it i cannot straighten my arm, i just let it fall back into position.
Nerves attached to the spine can grow if injured, but grow faster with a graft connecting the two ends. Nerves detached/avulsed from spine, cannot grow. Apologies to explain, but, people confuse these two. )
Prof T Carlstedth in London is pioneering this type of operation, they drill little holes into the spine and "plumb" the nerves in, thats what i had done. Not many people have had this type of operation, i was told i was the 20th person they had performed it on. Hopefully over time they will have enough research on it and will be able to offer more help than whats currently available.

Posts: 30
Joined: Mon Aug 18, 2008 12:57 am

Re: Who here has had success post avulsion, after surgery?

Post by swimhappy » Tue Nov 09, 2010 11:39 pm

I've had a graft, but not a transfer, if I'm reading the definitions correctly.

My accident was 11.5 years ago, and my surgery was 11 years ago. My arm has gone from being completely flail (6 of my nerves were avulsed) to having some movement. I never lost tricep function, but I did lose all bicep function. In the last year or so I've gained back some bicep. Not enough to be useful, but I think part of that is just that it's weak from not being used for almost 12 years. It gets stronger each day so we'll see where it finally ends up. I've also gained back some wrist flexion (that came at about 2 years post surgery and has only gotten stronger over the years) and a few finger twitches (about 3 years post surgery, but I haven't worked on any of it so it hasn't improved much since it first showed up).

I haven't gained back enough to not consider my arm paralyzed anymore, though. I will certainly not be doing any bicep curls anytime soon, that's for sure!

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