Staged Brachialis to Anterior Interosseous Nerve Transfer With Graft for Recovery of Grasp in the…

StudyOperative neurosurgery (Hagerstown, Md.)· Mar 2026

Staged Brachialis to Anterior Interosseous Nerve Transfer With Graft for Recovery of Grasp in the Tetraplegic Patient: Technical Report.

Stanley Bazarek, Marta Menegatti, Eric Herring … Justin M Brown

Peripheral NerveStudyTreatmentQ2IF 1.0

Staged brachialis-to-anterior interosseous nerve nerve transfer restored finger flexion in most tetraplegic limbs

Staged Brachialis to Anterior Interosseous Nerve Transfer With Graft for Recovery of Grasp in the Tetraplegic Patient: Technical Report.

Stanley Bazarek … Justin M Brown

Operative neurosurgery (Hagerstown, Md.) · Mar 2026 · Q2 in Surgery

Background

Nerve transfers have been shown to restore upper-extremity function after cervical spinal cord injury, but recovery of hand grasp remains a challenge.

Methods

Preoperative assessment includes physical examination and electrodiagnostic studies to confirm preserved innervation of both the brachialis donor and the backup elbow flexor, biceps brachii.

n = 23 limbs

78%

Results

78%

most regained useful finger flexion after the staged transfer

n = 23 limbs

More results

The medial brachial exposure allows for access to both the medial antebrachial cutaneous nerve graft and the brachialis nerve.

“

Conclusion · 1 of 2

The BRA-AIN is one of the few interventions available for recovery of hand grasp in the tetraplegic patient, but previous reports have shown less favorable outcomes.

Conclusion · 2 of 2

A 2-stage approach with an interpositional graft may address some of the limitations of the direct BRA-AIN transfer, improving outcomes.

Staged Brachialis to Anterior Interosseous Nerve Transfer With Graft for Recovery of Grasp in the Tetraplegic Patient: Technical Report.

Staged Brachialis to Anterior Interosseous Nerve Transfer With Graft for Recovery of Grasp in the Tetraplegic Patient: Technical Report.

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