Brachial Plexus Surgery
Brachial Plexus is a network of nerves that come from the spinal cord in the neck and travel down the arm. They send signals from the spine to the shoulder, hands, and arms. Nerves control the muscles of these areas and also provide feeling in the arm. Sometimes due to injury, the shoulder is forcefully pressed down away from the head that tears or stretch the nerves. Some of the injuries are minor and may recover with time and therapy. But almost all types of brachial plexus injury require pain control.
Pain or burning sensation is experienced in almost all the minor or severe cases of brachial injury. It can be controlled by the following:
- Drugs mainly nerve membrane stabilizers
- Anticonvulsant and antidepressant medications
- Transcutaneous electrical nerve stimulation (TENS) device delivers electrical impulses to the nearby nerve pathways to provide relief from pain.
If the injury is severe, is causing extreme pain, and fails to improve, then surgical intervention maybe required.
Types of surgery for Brachial plexus injury:
Ideally, the surgery for brachial plexus injury must occur within three to six months after injury. Surgery performed after this period reduces the desired results. In some cases, nerves from other body parts may be used to restore arm function. The various surgical procedures performed are:
- Nerve Graft: In this type of surgery, the injured section of the brachial plexus is removed and replaced with a class of nerves from other body structures. The procedure is like uniting a section of new nerves between the two classes of old nerves.
- Nerve Transfer: In this method, a less important nerve from the spinal cord is taken and fastened to the spinal cord at the location of the torn nerve root. Normally recovery may take several months after surgery, but it can be speeded by performing the surgery near the targeted muscle. It avoids repairing away from the muscle. A set of exercises performed regularly helps to keep the joints flexible. Splints may also be used to avoid the inward curling of the hand.
Rehabilitation after surgical intervention:
The rehabilitation plan is specific for each patient and is planned according to the severity of the injury and the type of treatment provided. It minimizes risks and reduces recovery time after surgery. It includes various processes like:
- Physical therapy and occupational therapy
- Electrical stimulation to prevent muscle atrophy till the nerves return to their original function
- Exercises shoulder extension, depression, flexion, etc. to improve the muscle function
- Stretching to improve and maintain the range of motion. It also increases the blood supply to the injury and help nerves to work properly
Dr Manish Vaish - Neurosurgeon
Neurosurgeon NCR, Delhi
Dr. Yashpal Bundela MS Mch
Dr.Girish Rajpal MS Mch FINR
Dr. Shiwani Jain MD FNB
PDFC (Neuro-anaesthesia and Critical care)
Dr Hrishikesh Chakrabartty
Dr.Praveen Kumar MS Mch
Dr. Manish Marda MD DM