What is brachial plexus reconstructive surgery?
The brachial plexus is a nerve bundle that allows mobility and sensation of the upper extremity, which includes the shoulder, arm and hand. The origin of this nerve bundle is in the spinal cord.
When a brachial plexus injury occurs, which is usually related to strong impacts such as a sports fall or an accident, there is a loss of mobility in the affected limb, generating great pain in the area. In this sense, reconstructive surgery of the brachial plexus is necessary, which consists of repairing the functional defects caused by the injury.
Why is it performed?
Brachial plexus injuries generally require surgery, but it depends on each specific case, since there are some cases in which the patient can recover without the need to undergo surgery.
Thus, brachial plexus reconstructive surgery is performed in those patients in whom recovery is slow, incomplete or in patients who fail to recover. And, although it is usually the most frequent treatment, surgery is not immediate. In fact, it is usually indicated between three and six months after the injury, because there are patients who manage to recover during this period.
In any case, it is important to perform the surgery at the right time, because the muscle may degenerate due to lack of movement and, consequently, the results of the surgery will not be favorable.
What does it consist of?
There are different surgical techniques for brachial plexus reconstruction, which vary according to the type and severity of the injury:
- Nerve graft: To reconstruct the injured nerve defect, a graft is placed as a bridge between the two boundaries of the injured nerve. In this way, the damaged nerves are connected. Generally, this bridge nerve is extracted from one of the lower extremities.
- Nerve transfers: This technique consists of using a healthy nerve adjacent to the injured nerve to reconstruct the nerve connection and thus repair the function of the limb.
- Neurolysis: This technique aims to decompress the scar tissue of the affected nerve that limits mobility.
- Palliative surgery: When the nerve cannot be reconstructed, there is the possibility of palliative surgery consisting of tendon transfer to restore function.
Preparing for brachial plexus reconstructive surgery
In order to perform reconstructive surgery of the brachial plexus, it is necessary to evaluate the area of the injury, as well as to take a complete medical history. The specialist may request an MRI and electromyography. In this way, he/she will be able to locate and accurately assess the damaged area, as well as check the mobility of the affected area.
In some cases, to evaluate the effectiveness of the treatment, the specialist may perform a controlled block to check the level of pain suffered by the patient.
Care after the operation
After surgery, patients should follow, for 6-12 months, physiotherapy and rehabilitation treatment with the aim of helping to regain function.