• Jie Chang, Binyu Wang, Lipeng Yu, Tong Wang, Tao Sui, Yi Zhu, Xiaojian Cao, and Kaixiang Yang.
• Department of Orthopedics, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
• Spine. 2022 Sep 1; 47 (17): 1248-1252.

Study DesignA total of 6 formalin-fixed cadavers were included in the cadaver feasibility study.ObjectiveThe aim was to ascertain the anatomical feasibility of extradural contralateral C7 ventral root transfer technique by cervical posterior.Summary Of Background DataUpper limb spastic hemiplegia is a common sequela after stroke. In our previous study, the authors established a method by transferring contralateral C7 dorsal and ventral roots to the corresponding C7 dorsal and ventral roots on the affected side in the cervical posterior.MethodsIn the present study, six formalin-fixed cadavers were dissected to confirm the anatomical feasibility. Experimental anastomosis in cadavers was conducted. The pertinent lengths of the extradural nerve roots were measured. The tissue structures surrounding regions between the extradural CC7 nerve roots and the vertebral artery were observed. The cervical magnetic resonance imaging scans of 60 adults were used to measure the distance between the donor and recipient nerves.ResultsExperimental anastomosis showed that the distance between the donor and recipient nerves was approximately 1 cm; the short segment of the sural nerve needed bridging. The distance between both exit sites of the exit of the extradural dura mater was 33.57±1.55 mm. The length of the extradural CC7 ventral root was 22.00±0.98 mm. The ventral distance (vd) and the dorsal distance (dd) in males were 23.98±1.72 mm and 30.85±2.22 mm ( P <0.05), while those in females were 23.28±1.51 mm and 30.03±2.16 mm, respectively. C7 vertebral transverse process, ligaments, and other soft tissues were observed between the vertebral artery and the extradural C7 nerve root.ConclusionUnder the premise of less trauma, our study shows that the extradural contralateral C7 ventral root transfer technique, in theory, yields better surgical results, including better recovery of motor function and complete preservation of sensory function.Level Of Evidence5.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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