Turkish Neurosurgery 2005 , Vol 15 , Num 4
Neurotization in the Treatment of Brachial Plexus Root Avulsion Injuries: A Case Report and Review of the Literature
Gökhan BOZKURT1, Selim AVHAN2, Cezmi Çağrı TÜRK2, Kemal BENLİ2
1Institute of Neurological Sciences and Psychiatry, Department of Neurosurgery
2Department of Neurosurgery, School of Medicine, Hacettepe University, Altındağ, Ankara, Turkey
INTRODUCTION: Brachial plexus root avulsion injuries cannot be repaired by neurorrhaphy or nerve grafting. There is no possibility of spontaneous recovery and these injuries occur most often in individuals who are in their productive period. At present, the best surgical treatment option for brachial root avulsion injury is neurotization.

OBJECTIVE: To describe the importance of neurotization in the treatment of brachial plexus root avulsion injury in view of the literature.

CASE: A thirty-year-old male patient, who had suffered a traffic accident 6 months ago, was referred to our clinic because of ongoing severe pain refractory to medical treatment and weakness of the left arm. A complete brachial plexus lesion in the form of a root avulsion was diagnosed after neurological and radiological evaluation. Neuroneural neurotization was performed. The spinal accessory nerve, phrenic nerve and cervical plexus were used as donor nerves while the sural nerve was the choice as inter-graft material. In this patient with adult type brachial plexus injury, pain decreased in the early post-surgical period and there was no change in neurological examination at 6 months follow-up.

CONCLUSION: One of the greatest problems for peripheral nerve surgeons is treating functional loss due to brachial plexus injuries. It takes a long time to regain lost function after neurotization in brachial plexus root avulsion injuries. Physical therapy and rehabilitation are very important in the postoperative period. It should always be kept in mind that the acquirement of even some function is important for the patient. Keywords : Brachial plexus injuries, Root avulsion, Neurotization

Corresponding author : Gökhan Bozkurt, gbozkurt@hacettepe.edu.tr