Fig. 1

Intra-operation photograph of a clinical practice, illustrating the modified cC7 nerve transfer procedure. Microdissection was carried out to isolate the divisions of the right (donor side) C7 as distally as possible before joining the corresponding cords. Next, the anterior and posterior divisions of the C7 (ADC7, PDC7) were disconnected beneath the sternocleidomastoids and traced to the contralateral side. The C8 and T1 roots on the left (recipient side) were disconnected at the level of the intervertebral foramen and pulled distally beneath the clavicle to the proximal part of the pectoralis major (PM). After the nerve suture site was determined, another transverse incision on the anterior middle neck was made, followed by direct neurorrhaphy. The patient was a 48-year-old male