Brachial Plexus Injury Related to Patient Positioning

2007 ◽  
Vol 18 (7) ◽  
pp. 833-834 ◽  
Author(s):  
Anil Kumar Pillai ◽  
Hector Ferral ◽  
Sudhen Desai ◽  
Sudheer Paruchuri ◽  
Scott Asselmeier ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Patient Positioning

Prolonged brachial plexus neuropathy: a rare complication following protracted endometriosis surgery in Lloyd-Davies position

2021 ◽  
Vol 14 (11) ◽  
pp. e243408
Author(s):  
Anna Katrina Hay ◽  
Anna McDougall ◽  
Peter Hinstridge ◽  
Sanjeev Rajakuldendran ◽  
Wai Yoong
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Rare Complication ◽  
Patient Positioning ◽  
Sensory Innervation ◽  
Plexus Brachialis ◽  
Clinical Anatomy ◽  
Reduction Strategies ◽  
Risk Reduction Strategies ◽  
Endometriosis Surgery

Brachial plexus injury is a rare but potentially serious complication of laparoscopic surgery. Loss of motor and/or sensory innervation can have a significant impact on the patient’s quality of life following otherwise successful surgery. A 38-year-old underwent elective laparoscopic management of severe endometriosis during which she was placed in steep head-down tilt Lloyd-Davies position for a prolonged period. On awakening from anaesthesia, the patient had no sensation or movement of her dominant right arm. A total plexus brachialis injury was suspected. As advised by a neurologist, an MRI brachial plexus, nerve conduction study and electromyography were requested. She was managed conservatively and made a gradual recovery with a degree of residual musculocutaneous nerve neuropathy. The incidence of brachial plexus injury following laparoscopy is unknown but the brachial plexus is particularly susceptible to injury as a result of patient positioning and prolonged operative time. Patient positioning in relation to applied clinical anatomy is explored and risk reduction strategies described.

Brachial plexus injury following spinal surgery

2010 ◽  
Vol 13 (4) ◽  
pp. 552-558 ◽  
Author(s):  
Juan S. Uribe ◽  
Jaya Kolla ◽  
Hesham Omar ◽  
Elias Dakwar ◽  
Naomi Abel ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Spinal Surgery ◽  
Brachial Plexus Injury ◽  
Patient Positioning ◽  
Electrophysiological Monitoring ◽  
Duration Of Surgery ◽  
Intraoperative Electrophysiological Monitoring ◽  
Special Concern ◽  
Injury Recovery ◽  
Determining Factor

Object In the present study, the authors identified the etiology, precipitating factors, and outcomes of perioperative brachial plexus injuries following spine surgery. Methods We reviewed all the available literature regarding postoperative/perioperative brachial plexus injuries, with special concern for the patient's position during surgery, duration of surgery, the procedure performed, neurological outcome, and prognosis. We also reviewed the utility of intraoperative electrophysiological monitoring for prevention of these complications. Results Patient malpositioning during surgery is the main determining factor for the development of postoperative brachial plexus injury. Recovery occurs in the majority of cases but may require weeks to months of therapy after initial presentation. Conclusion Brachial plexus injuries are an increasingly recognized complication following spinal surgery. Proper attention to patient positioning with the use of intraoperative electrophysiological monitoring techniques could minimize injury.

RESTORATION OF HAND FUNCTION AFTER BRACHIAL PLEXUS INJURY

Hand Clinics ◽  
1995 ◽  
Vol 11 (4) ◽  
pp. 647-656
Author(s):  
Chantal Bonnard ◽  
Algimantas Narakas
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Hand Function

scholarly journals Role of MRI in the diagnosis of adult traumatic and obstetric brachial plexus injury compared to intraoperative findings

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doria Mohammed Gad ◽  
Mostafa Thabet Hussein ◽  
Nagham Nabil Mahmoud Omar ◽  
Mohamed Mostafa Kotb ◽  
Mohamed Abdel-Tawab ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Tissue Characterization ◽  
Brachial Plexus Injury ◽  
Imaging Modality ◽  
Preoperative Evaluation ◽  
Diagnostic Modality ◽  
Non Invasive ◽  
Upper Limb Function ◽  
Obstetric Brachial Plexus ◽  
Sensitivity Specificity

Abstract Background Brachial plexus injury occurs following birth trauma or adult trauma as well, surgical repair is important to regain upper limb function, and preoperative evaluation with MRI is important and considered the accurate and safe imaging modality. Thirty-seven patients with clinically suspected obstetric (15 patients) or adult traumatic (22 patients) brachial plexus injury were included in our study; all of them underwent MRI examination including T1WI, T2WI, STIR, DWIBS, 3D STIR SPACE, and MR myelography sequences. Results In obstetric cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 63%, 89%, and 82%, respectively, while for postganglionic lesions, MRI sensitivity, specificity, and accuracy were 60%, 99%, and 95%, respectively. In adult cases, MRI sensitivity, specificity, and accuracy for preganglionic injury were 96%, 95%, and 95% respectively, while for postganglionic injury, MRI sensitivity, specificity, and accuracy were 60%, 100%, and 99%, respectively. Conclusion MRI represents a safe, non-invasive, diagnostic modality having the multiplanar capability and better soft tissue characterization.

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