Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Anatomic feasibility of intercostal-to-femoral and ulnar-to-sciatic nerve transfers for lower extremity neurotization after traumatic spinal cord injury.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Gutama Barite, Cornely Ronald M, Gergoudis Franklin, Torres-Guzman Ricardo, Chen Shirely, Thayer Wesley, Bhandari Panambur L
Аннотация
BACKGROUND: Traumatic spinal cord injury (SCI) is associated with functional morbidity and limited options for restoring lower extremity motor function. We explored the technical feasibility of intercostal-to-femoral and ulnar-to-sciatic nerve transfers as a potential approach to reinnervate the lower limb following SCI.
METHODS: A cadaveric anatomical feasibility study was performed using a fresh-frozen adult human specimen to evaluate two novel nerve transfer strategies: posterior intercostal-to-femoral and long-segment ulnar-to-sciatic nerve transfers. Dissections assessed the ability to achieve direct, tension-free coaptation without interposition nerve grafts.
RESULTS: Intercostal nerves T8-T10 were successfully harvested, mobilized, and tunneled to the proximal femoral nerve, demonstrating >2 cm overlap sufficient for tension-free coaptation. Similarly, long-segment ulnar nerve harvest from the hypothenar region to axilla enabled subcutaneous tunneling to the gluteal region and direct end-to-end coaptation with the sciatic nerve with >2 cm overlap and without the need for grafting. Both nerve transfer techniques avoided excessive tension at the coaptation sites.
CONCLUSIONS: These findings establish the anatomic feasibility of intercostal-to-femoral and ulnar-to-sciatic nerve transfers and provide a practical anatomic foundation for future translational studies aimed at restoring lower extremity function in patients with SCI.
METHODS: A cadaveric anatomical feasibility study was performed using a fresh-frozen adult human specimen to evaluate two novel nerve transfer strategies: posterior intercostal-to-femoral and long-segment ulnar-to-sciatic nerve transfers. Dissections assessed the ability to achieve direct, tension-free coaptation without interposition nerve grafts.
RESULTS: Intercostal nerves T8-T10 were successfully harvested, mobilized, and tunneled to the proximal femoral nerve, demonstrating >2 cm overlap sufficient for tension-free coaptation. Similarly, long-segment ulnar nerve harvest from the hypothenar region to axilla enabled subcutaneous tunneling to the gluteal region and direct end-to-end coaptation with the sciatic nerve with >2 cm overlap and without the need for grafting. Both nerve transfer techniques avoided excessive tension at the coaptation sites.
CONCLUSIONS: These findings establish the anatomic feasibility of intercostal-to-femoral and ulnar-to-sciatic nerve transfers and provide a practical anatomic foundation for future translational studies aimed at restoring lower extremity function in patients with SCI.