Semi-quantitative electromyography as a predictor of nerve transfer outcome

• 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
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2019.02.008

•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.