Spectrum of Brachial Plexus Injuries: Our 10 Years’ Experience

Authors

  • Deepak Agrawal Department of Neurosurgery, AIIMS, New Delhi, India
  • Rati Agrawal Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Gurudutta Satyarthee Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Shashwat Mishra Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Hitesh Gurjar Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Rajesh Meena Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Ramesh Doddamani Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Amandeep Jagdevan Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Satish Kumar Verma Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Kanwaljeet Garg Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Pankaj Kumar Singh Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
  • Dattaraj Sawarkar Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India

Keywords:

brachial plexus injury, neurolysis, neurotization

Abstract

Introduction Traumatic brachial plexus (TBP) injuries are disabling injuries with profound functional deficits. Patients often suffer from debilitating pain, substantial psychological trauma, and variegated socioeconomic disabilities. The aim of this study was to analyze the outcome of patients with TBP injuries operated in our center.

Material and Methods In this retrospective study, demographic details, mode of injury, various surgical interventions, and the neurological outcomes of the TBP injury patients operated at our center in the past 10 years (2011–2023) were analyzed.

 Results There were 227 patients with TBP injury (114 patients with pan-brachial plexus injury and 113 patients with partial brachial plexus injury). The majority of them were males (96.48%). Around 75% of the patients were aged between 21 and 40 years. Mode of injury was road traffic accidents in 94.71% cases. In all, 31.28% of cases underwent surgery within 6 months after the injury, while around 47% cases were operated on 6 months after the injury. One hundred and eighty-five patients (81.50%) underwent neurotization and in 37 patients (16.30%) only neurolysis was done without neurotization. Neurological improvement was seen in 70% of the patients who underwent surgery within 3 months after injury, while patients who underwent surgery at 4 to 6 and 7 to 12 months after injury had 42.25 and 47.17% improvement, respectively, but as the time interval increased, improvement drastically fell to 26.09 and 14.29%, respectively, in patients who underwent surgery between 13 and 24 and greater than 24 months after injury.

Conclusion Both neurotization and neurolysis are beneficial for TBP injury patients. Patients who underwent surgery within a 1 year of injury had a far better outcome than patients who were operated on after a 1-year period. Nevertheless, our study shows that surgical repair should be offered to all patients of TBPI, even after 24 months of injury as at least 15% will have good recovery of motor power following surgery.

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Published

2022-10-10

Issue

Vol. 6 No. 1 (2022): Journal of Peripheral Nerve Surgery

Section

Research