Contralateral sacral 1 root transection and transfer for lumbosacral plexus avulsion injuries: A systematic review

Contralateral sacral roots (cS1) transfer to treat avulsion injuries of lumbosacral plexus (LSP) has been described, however; concerns about its safety remain. We performed a systematic review of a hypothesis regarding safety of cS1 transection and transfer for treatment of LSP avulsion injuries from available studies. A literature search on Pub Med, Cochrane database and Goggle scholar was performed using appropriate key words for choosing relevant articles. Two authors independently assessed the methodological quality of selected articles using Brink’s criteria and results were analysed using level of evidence. The literature search retrieved a total of 877 publications; out of which 9 articles met the inclusion criteria and were reviewed. 6 articles were investigated for both the reliability and validity and 3 articles evaluated qualitatively; all were of limited quality. Though all studies showed that cS1 nerve root transfer leads to improvement in motor power of muscles and sensory recovery neurotised by cS1 with transient donor site morbidity however; evidence is limited. cS1 nerve root transection and transfer for the repair of LSP avulsion injury appears to be a safe option but the evidence is limited and further validation of this finding is needed.