Nerve reconstruction in lumbosacral plexopathy. Case report and review of the literature.

Abstract:

:Neurological injury to the lumbosacral plexus associated with pelvic and sacral fractures has traditionally been treated conservatively, despite significant and often debilitating functional deficits of the lower extremities. The authors report a case of reconstruction of the lumbosacral plexus, including nerve grafting to restore lower-extremity function caused by severe trauma to the pelvis. A 16-year-old boy sustained pelvic and sacral fractures in a motor vehicle accident. After stabilization of his orthopedic injuries, he suffered from paresis of his right gluteal and hamstring muscles and had no motor or sensory function below his knee. Two months later, he underwent reconstruction of his lumbosacral plexus performed using a nerve graft from his L-5 and S-1 nerve roots proximal to the inferior gluteal nerve and distal to a branch to the hamstring muscles. After another 2 months, his recovering saphenous nerve was transferred to the sensory component of the posterior tibial nerve by using cabled sural nerve grafts to restore sensation to the sole of his foot. After 2.5 years, he experienced reinnervation of his gluteal and hamstring muscles and could perceive vibration on the sole of his foot. With the assistance of a foot-drop splint, the patient ambulates well and is able to ski. Operative details and the relevant literature are reviewed.

journal_name

J Neurosurg

journal_title

Journal of neurosurgery

authors

Tung TH,Martin DZ,Novak CB,Lauryssen C,Mackinnon SE

doi

10.3171/ped.2005.102.1.0086

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

86-91

issue

1 Suppl

eissn

0022-3085

issn

1933-0693

journal_volume

102

pub_type

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