Impact of Severe Cervical Foraminal Stenosis on Contralateral C7 Nerve Transfer Outcomes

Abstract

This report presents the case of a 67-year-old male patient with severe bilateral C6/7 foraminal stenoses who underwent contralateral seventh cervical nerve (C7) transfer as a treatment for left spastic hemiparesis resulting from a right middle cerebral artery infarction. The initial postoperative results showed improved spasticity and motor function, but these gains plateaued and even receded, unlike other studies that noted progress at 10–18 months post-surgery. We hypothesized that the presence of C7 radiculopathy due to severe cervical foraminal stenosis may affect long-term outcomes after contralateral C7 transfer and serve as a contraindication for this surgery. These findings emphasize the importance of thoroughly assessing patients with cervical foraminal stenosis and the associated risk of radiculopathy before considering a contralateral C7 transfer. Further research is needed to assess the prevalence of cervical foraminal stenosis in patients undergoing contralateral C7 transfer and explore alternative surgical approaches or adjunctive treatments to optimize postoperative outcomes.