To explore the clinical efficacy of contralateral seventh cervical nerve root transposition in the treatment of residual spastic hemiparesis after hypertensive intracerebral hemorrhage surgery.

A retrospective analysis was conducted on the clinical data of 6 patients with spastic hemiparesis admitted to the Department of Neurosurgery, Zhoukou Central Hospital from January to June 2021. Among them, 5 cases were primary hypertensive intracerebral hemorrhage and 1 case was gestational hepertension. All cases had spastic hemiplegia after surgical removal of intracranial hematoma. After ineffective rehabilitation training, all patients underwent contralateral seventh cervical nerve root transposition. The modified Ashworth scale (MAS) was used to assess the muscle tone of the affected limb; the simplified Fugl-Meyer motor function scale (FMA) was used to assess upper limb motor function; the Berg balance scale (BBS) was used to evaluate patients′ postural balance; and the Boston Diagnostic Aphasia Examination (BDAE) scale was used to grade patients′ language function.

The surgery was successfully completed in all 6 patients. There was no change in muscle strength of the contralateral limb after surgery, while numbness of the contralateral limb occurred in all patients and disappeared within 6 months after surgery. Weakness of the contralateral limb occurred in 5 cases and disappeared within 3 months after surgery, and neck swelling occurred in 4 cases and disappeared within 1 week after surgery. There were no other complications such as incision infection, respiratory difficulty, or sensation of swallowing foreign bodies. The differences in MAS grade, FMA score, and BBS score between preoperative, postoperative 6 months, and postoperative 12 months were statistically significant in all 6 patients (all P<0.05). Compared with preoperative values, muscle tone and upper limb motor function improved at 6 and 12 months postoperatively, and postural balance function improved at 12 months postoperatively, with statistically significant differences (all P<0.05). There were no statistically significant differences in BDAE grades of language function between preoperative, postoperative 6 months, and postoperative 12 months (F=3.71, P=0.156).

Contralateral seventh cervical nerve root transposition can improve muscle tone of the affected limb, enhance upper limb motor function, and improve postural balance in patients with spastic hemiparesis. It is an effective treatment method.

Hemiplegia; Brachial plexus; Treatment outcome; Contralateral sevevth cervical nerve root transposition