Applied anatomy of C_7 nerve transfer and anterior lumbar spinal roots anastomosis in vertebral canal to restore the lower limb function of paraplegia

Objective: To provide anatomic basis for C7 nerve transfer to anastomose anterior lumbar spinal nerve in vertebral canal to restore the lower limb function of paraplegia. Methods: The correlation and the number of nerve fibre of lumbar spinal nerve at the L1 level, the transfer route of C7 nerve, the length and the number of fibre of the sciatic nerve were noted on 20 adult cadaveric specimens. Results: The length of the C7 passed through the anterior side of vertebral body was about (2.4±0.58)cm, which can be anastomosed with the contralateral C7 nerve. At the level of L1, the L1-L4 anterior lumbar spinal nerves can be identified and anastomosed. Tibial and peroneal nerves can be cut about (52.35±2.60) cm and (48.20±2.37) cm respectively, which was suitable for the distance of (48.35±3.36)cm from C7 to L1. The number of fibres of the distal tibial nerve of (26856±112), and that of the distal peroneal nerve of (25700±156) was more than that of anterior branch of L1-4 (20766±354). Conclusions: The sciatic nerve can be regarded as the optimum bridging nerve. The double C7 nerve waved into beam through the prespinal route can be selected as transfer nerve. It is feasible to identify and anastomose the L1-L4 anterior lumbar spinal nerves at the L1 level.