Nerve transfers (neurotizations) performed under optimal conditions can restore some voluntary control in muscles of the upper extremities in patients with tetraplegia. However, the type of motoneuron lesions in target muscles for nerve transfers influences the functional outcome. Using standardized maps of motor point topography, surface electrical stimulation reliably defines the kind and extent of motoneuron lesion in the selected muscles. In a muscle with an intact lower motor motoneuron, nerve transfers can often successfully reinnervate the chosen key muscle. Conversely, in a lower motoneuron lesion, the nerve transfer outcome is less predictable. However, direct muscle stimulation appears to ameliorate the morphological precondition, a finding which necessitates new preoperative approaches to optimize reinnervation in denervated/partially denervated muscles. Therefore, understanding the impact of electrical stimulation in diagnostics, prognostics and treatments of upper limbs in tetraplegia is critical for neurotization procedures.

中文翻译：

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四肢瘫痪的上下运动神经元病变-对手术神经转移以恢复手功能的影响-小型回顾。

在最佳条件下进行的神经转移（神经旋转）可以恢复四肢瘫痪患者上肢肌肉的一些自愿控制。但是，用于神经传递的目标肌肉中运动神经元病变的类型会影响功能结果。使用运动点地形的标准化地图，表面电刺激可靠地定义了选定肌肉中运动神经元病变的类型和程度。在具有完整的下运动神经元的肌肉中，神经传递通常可以成功地重新激活所选的关键肌肉。相反，在较低的运动神经元病变中，神经转移的结果难以预测。但是，直接肌肉刺激似乎可以改善形态学前提，这一发现需要采取新的术前方法来优化失神经/部分失神经的肌肉的神经支配。因此，了解电刺激对四肢瘫痪的上肢的诊断，预后和治疗的影响对于神经化手术至关重要。