Effects of methylcobalamin in neurotisation after brachial plexus injury. A controlled study

Abstract

Objective: To find out the clinical effects of methylcobalamin on the recovery of active elbow flexion after neurotisation in brachial plexus injury. Design: Controlled single-blind trial with a 2-year follow-up. Patients: One hundred and seventy-nine male patients with isolated total root avulsion brachial plexus injury treated within 6 months of the injury were recruited in this study. Intervention: Exploration of the plexus and ipsilateral spinal accessory nerve neurotisation were carried out in every patient by using a sural nerve graft connecting the spinal accessory nerve to the musculocutaneous nerve. After surgery, patients were randomly allocated to two groups, the control group (89 patients) and the methylcobalamin group (90 patients). In both groups, conventional postoperative medication and rehabilitation programmes were carried out and the patients were followed up periodically for 2 years; however, in the methylcobalamin group, methylcobalamin 1.5 mg/day (in three divided doses) was given to patients during the follow-up period. Results: Electrodiagnosis revealed significantly more rapid reinnervation of elbow flexor muscles in the methylcobalamin group (p < 0.05). Motor power was also significantly better in the patients who received methylcobalamin (p < 0.05). Conclusions: Methylcobalamin can promote active elbow flexion in the brachial plexus of injured patients who underwent spinal accessory neurotisation.