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Brachial plexus surgery

The brachial plexus

The network of nerves running from the spine to the shoulder, arm and neck are known as the brachial plexus. The brachial plexus is responsible for controlling the sensation and movement of the upper limbs. 

What problems occur in the brachial plexus?

A brachial plexus injury (BPI) refers to any condition that affects the nerves in the brachial plexus. Common symptoms of a BPI include pain, limited muscle control, loss of sensation, muscle weakness and in more severe cases paralysis. People can sustain BPIs through:

  • sports
  • high-speed vehicle accidents; and 
  • blunt trauma. 

How do you diagnose a BPI?

MRI diagnosis

Diagnosis of a BPI will typically include discussing patient history, a clinical examination, imaging studies (such as a CT or MRI scan) and electrodiagnostic testing. Repeat testing may be necessary in order to monitor the injury.

What treatment is available? 

Sometimes, a BPI will fully heal on its own. However, surgical intervention is necessary for more severe cases, especially if you have sustained an avulsion or rupture to the brachial plexus. An avulsion is where the nerve is pulled from the spinal cord, whereas a rupture is where the nerve has been torn or stretched.   

There are various surgical procedures for BPIs. A patient may need to have nerve transfers (neurotisation), where less significant nerves are transferred to the damaged nerve. Alternatively they may have to undergo a neuroma excision, where the swollen nerve is removed, a neurolysis, where the scar tissue surrounding the nerve is removed, or nerve grafting, where the damaged nerve is replaced with a section of a healthier nerve.

You consultant will discuss with you the best treatments options for you. 
 

Acknowledgements: EIDO Healthcare Limited

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