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

Thomas H. Tung, D. Zachary Martin, Christine B. Novak, Carl Lauryssen, Susan E. Mackinnon

Research output: Contribution to journalReview article

15 Scopus citations

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.

Original languageEnglish
Pages (from-to)86-91
Number of pages6
JournalJournal of neurosurgery
Volume102 PEDIATRICS
Issue numberSUPPL. 1
StatePublished - Jan 1 2005

Keywords

  • Lumbosacral plexopathy
  • Nerve graft
  • Nerve injury
  • Pediatric neurosurgery
  • Pelvic/sacral fracture

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