Brachial Plexus and Peripheral Nerve Reconstruction
Also known as: surgery for brachial plexus injury, peripheral nerve surgery.
What is the peripheral nervous system?
The peripheral nervous system is composed of the nerves that exit and enter the brain and spinal cord to control the muscles of the body and provide sensory input to the brain. Unlike injury to the central nervous system (composed of the brain and spinal cord), injury to the peripheral nervous system (composed of the rest of the nerves in the body) can often heal itself or be repaired with surgery.
What is the brachial plexus?
The brachial plexus is a bundle/network of peripheral nerves located in the area of the neck and shoulder. The plexus, also known as a network, begins as 5 nerves in the neck, exiting the spinal cord and contributing to branches (peripheral nerves) that extend into the shoulder, arm, forearm and hand. These nerves supply the muscles of the upper extremity with signals that start in the brain, and carry sensory information from the upper extremity back to the brain.
How is the peripheral nervous system (including the brachial plexus) injured and how is it repaired?
Injury to the peripheral nervous system can occur from a variety of causes. The nerves can be cut, stretched, crushed, or squeezed (compressed). The nerves can also be injured by toxins (sugar in the case of diabetes), alcohol, heavy metals, some infections and some autoimmune conditions (such as amyloidosis and sarcoidosis).
When nerves are injured, occasionally, they can heal on their own. When peripheral nerves are unable to heal on their own, surgery is typically required to free them from scar, or it may be performed to repair or reconstruct them. Reconstruction of injured nerves can be performed with grafts from another part of the body, or transfers from a working muscle to a non-functioning muscle.
Are any special tests required?
In some cases, special tests are required to provide additional diagnostic and prognostic information. These include nerve conduction studies, electromyography, X-rays, CT scans and MRIs.
Is any special preparation needed?
Certain medications, food and drink will need to be avoided for a period of time before the procedure is performed. Some patients may be required to wait to ensure that the injury cannot heal on its own before the procedure is performed.
What are the risk factors?
Failure to correct the nerve problems is a possibility with this complex procedure. The recovery process from brachial plexus and peripheral nerve reconstruction is usually lengthy and requires extensive physical therapy and other interventions during recovery.
Reviewed by: Aaron J Berger, MD
This page was last updated on: January 14, 2020 09:55 AM
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Birth-related Brachial Plexus Injury
Birth-related brachial plexus palsy refers to injury of the nerves that lead from the cervical (neck) spinal cord to the arm. These nerves can be injured during a difficult delivery. The result is weakness and/or loss of sensation in the affected arm.
Traumatic Brachial Plexus Injury
Injury to the brachial plexus can occur from a variety of causes. The nerves can be cut, stretched, crushed, or squeezed (compressed). Stretch or impact of the neck, shoulder or arm can lead to injuries to the nerves of the brachial plexus.