Brachial Plexus and Spinal Nerve Monitoring

2022 ◽  
pp. 171-186
Author(s):  
Arbaz A. Momin ◽  
Maxwell Y. Lee ◽  
Navkiranjot Kaur ◽  
Michael P. Steinmetz
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
Nerve Monitoring

Adult Total Brachial Plexus Injury

2018 ◽  
Author(s):  
Mustafa Nadi ◽  
Rajiv Midha
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Nerve Transfer ◽  
High Energy ◽  
Spinal Nerve ◽  
Adult Males ◽  
Cervical Spine Injuries ◽  
Improved Outcomes ◽  
Timely Fashion ◽  
Microsurgical Techniques

Total brachial plexus injury (BPI) typically results from high-energy vehicular accidents, affects mostly young adult males, and produces a flail, insensate limb. Because of the association of total BPI with head and cervical spine injuries, diagnosis might be delayed. Recognizing patients with total BPI and using electrodiagnostic and imaging tests in a timely fashion are critical. Advances in microsurgical techniques, primary nerve transfer, appropriate nerve graft utilization from a remaining intact (often C5) spinal nerve root, and free muscle transfers have improved outcomes. However, limited recovery even after reconstruction and severe deafferentation pain both remain challenging problems that further advancements will need to overcome.

Contributions of the fourth spinal nerve to the brachial plexus without prefixation

2008 ◽  
Vol 8 (6) ◽  
pp. 548-551 ◽  
Author(s):  
R. Shane Tubbs ◽  
Marios Loukas ◽  
Mohammadali M. Shoja ◽  
Mohammad R. Ardalan ◽  
Nihal Apaydin ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Statistical Significance ◽  
Spinal Nerve ◽  
Cervical Cord ◽  
Type I ◽  
Type Ii ◽  
Neural Connections ◽  
Pathological Conditions ◽  
Spinal Axis ◽  
Ventral Roots

Object The intradural contributions of the C-4 nerve rootlets have not been previously evaluated for their connections to the brachial plexus. The authors undertook a cadaveric study to evaluate the C-4 contributions to the upper trunk of the brachial plexus. Methods The posterior cervical triangles from 60 adult cadavers were dissected. All specimens that were found to have extradural C-4 contributions to the upper trunk of the brachial plexus were excluded from further study. In specimens found to have no extradural C-4 contributions to the brachial plexus a C1–T1 laminectomy was performed. Observations were made of any neural communications between adjacent spinal rootlets, specifically between C-4 and C-5. Results Nine (15%) of the 60 sides were found to have extradural C-4 contributions to the upper trunk of the brachial plexus. These sides were excluded from further study. No specimen was found to have a postfixed brachial plexus. Of the remaining 51 sides, 11 (21.6%) were found to have intradural neural connections between C-4 and C-5 dorsal rootlets and 1 (1.96%) had a connection between the ventral roots of C-4 and C-5. Communications between these 2 adjacent dorsal cervical cord levels were of 3 types. Type I was a vertical communication between the more horizontally traveling dorsal roots. Type II was a forked communication between adjacent C-4 and C-5 dorsal rootlets. The Type III designation was applied to connections between ventral rootlets. Although communications were slightly more frequent on left sides, this did not reach statistical significance. Conclusions In ~ 20% of normally composed brachial plexuses (those with extradural contributions from only C5–T1) we found intradural C4–5 neural connections. Such variations may lead to misinterpretation of spinal levels in pathological conditions of the spinal axis and should be considered in surgical procedures of this region, such as rhizotomy.

A Fourth Type of Brachial Plexus Lesion: The Intermediate (C7) Palsy

1991 ◽  
Vol 16 (5) ◽  
pp. 492-494 ◽  
Author(s):  
G. A. BRUNELLI ◽  
G. R. BRUNELLI
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
The Other ◽  
Brachial Plexus Lesion ◽  
Anterior Position ◽  
Different Types ◽  
New Type ◽  
Posterior Direction ◽  
Plexus Lesion ◽  
Total Type

A new type of brachial plexus lesion has been defined to be added to the classical types, i.e. the upper (Duchenne Erb), the lower (Dejerine Klumpke) and the total type. This new type is the intermediate palsy. The lesion is a partial involvement of the plexus, the predominant lesion of which involves C7 with a variable involvement of the upper or lower plexus. By observations during operation, and in cadavers, three different mechanisms are considered responsible for the three different types of lesion. A trauma with downwards traction principally involves the upper plexus. Trauma in abduction first involves the lower plexus while a traumatic force acting from an anterior to a posterior direction involves firstly and predominantly the C7 spinal nerve which is in an anterior position and less oblique than the other roots. Avulsion from the cord or rupture are possible. 33 cases have been observed.

Gait analysis after neurorrhaphy in the brachial plexus

2015 ◽  
Vol 18 (2) ◽  
pp. 367-370 ◽  
Author(s):  
P. Reichert ◽  
Z. Kiełbowicz ◽  
J. Kuryszko ◽  
A. Bocheńska
Keyword(s):  
Statistical Analysis ◽  
Brachial Plexus ◽  
Gait Analysis ◽  
Group Versus ◽  
Spinal Nerve ◽  
Control Group ◽  
Nerve Function ◽  
Animal Locomotion ◽  
Spinal Nerves ◽  
Potential Use

Abstract The gait is a form of human and animal locomotion on land by using limbs. The study assessed functional recovery after end to side and side to side neurorrhaphy the ventral branches of the C5 and C6 spinal nerves to the C7 spinal nerve on the rabbit brachial plexus. Gait statistical analysis showed significant differences between the control group versus the end-to-side and side to side neurorrhaphy groups, in opposite to the comparison between the two experimentals groups. Gait analysis results corresponded with the histomorphometric results. The results indicate the potential use of gait analysis for the assessment of the recovery of nerve function.

Repair of ruptured spinal nerve roots in a brachial plexus lesion

1995 ◽  
Vol 82 (4) ◽  
pp. 661-663 ◽  
Author(s):  
Thomas Carlstedt ◽  
Georg Norén
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
Sensory Loss ◽  
Spinal Root ◽  
Nerve Roots ◽  
Content Type ◽  
Nerve Grafts ◽  
Functional Gain ◽  
Plexus Lesion ◽  
Intrinsic Hand Muscles

✓ A 22-year-old woman sustained a brachial plexus injury with supraganglionic rupture of the C-8 and T-1 nerve roots as a result of a traffic accident. She was operated on approximately 1 week following the accident. After a hemilaminectomy, the intradural defects in the ruptured roots were bridged with sural nerve grafts. Within 3 years she recovered function in all muscles supplied from the lower roots in the plexus except for the intrinsic hand muscles, but she had a persisting, complete sensory loss in the ulnar nerve distribution. The possibility for functional gain after repair of spinal root lesions in brachial plexus patients is discussed.

Neuromuscular Innervation

Neuroanatomy ◽  
2017 ◽  
pp. 59-94
Author(s):  
Adam J Fisch
Keyword(s):  
Brachial Plexus ◽  
Spinal Nerve ◽  
Sensory Innervation ◽  
Lumbosacral Plexus

This chapter focuses on learning the process and components of neuromuscular innervation. Instructions are given on how to draw the brachial plexus, terminal nerves, lumbosacral plexus, peroneal nerves, tibial nerves, and dermatomal maps of spinal nerve sensory innervation. The chapter provides key landmarks along the dermatomal maps of sensory innervation, as well as syndromes associated with the various structures involved in neuromuscular innervation.

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