Semi-quantitative electromyography as a predictor of nerve transfer outcome

•Neurophysiology has great potential for nerve transfer surgery planning.•A rapid semi-quantitative interference pattern analysis technique helps to select donor nerves.•Even 2 years since denervation should not prevent referral to a reconstructive neurosurgeon. Evaluate correlation between donor ne...

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Bibliographic Details
Published in:Clinical neurophysiology 2019-05, Vol.130 (5), p.701-706
Main Authors: Mandeville, Ross M., Brown, Justin M., Sheean, Geoffrey L.
Format: Article
Language:English
Subjects:
Adult
Brachial Plexus - injuries
Brachial Plexus - surgery
Electromyography
Electromyography - methods
Female
Humans
Male
Middle Aged
Nerve transfer
Nerve Transfer - methods
Neurophysiology
Peripheral Nerve Injuries - surgery
Prognosis
Quantitative neurophysiology
Reconstructive neurosurgery
Recovery of Function - physiology
Retrospective Studies
Spinal cord injury
Treatment Outcome
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Summary:•Neurophysiology has great potential for nerve transfer surgery planning.•A rapid semi-quantitative interference pattern analysis technique helps to select donor nerves.•Even 2 years since denervation should not prevent referral to a reconstructive neurosurgeon. Evaluate correlation between donor nerve semi-quantitative electromyography (sqEMG) and strength outcome in nerve transfer surgery. Retrospective review of pre-operative donor nerve semi-quantitative neurophysiology and post-operative recipient muscle force after at least one-year follow-up. The semi-quantitative technique is the average motor unit number estimate associated with needle recorded interference patterns in the donor muscle (IP-AMUNE), which was correlated with hand-held manometry, standardized as a percent of the contralateral arm, using multivariable linear regression with backward selection. Twenty-eight nerve transfer cases were included. The correlation between the donor nerve IP-AMUNE and the recipient muscle strength was moderate to strong and highly significant (r = 0.67, p  0.54). IP-AMUNE is a good predictor of strength after nerve transfer surgery and should be considered in the evaluation and planning of patients undergoing nerve transfer to aid in donor nerve selection. IP-AMUNE may significantly benefit those undergoing nerve transfer surgery for the restoration of movement.
ISSN:1388-2457
1872-8952
DOI:10.1016/j.clinph.2019.02.008