Follow-up evaluation of neurolysis of brachial plexus and peripheral nerves of upper extremities.
BACKGROUND
The work presents the results of neurolysis of brachial plexus and peripheral nerves of upper extremities performed in the Neurosurgical clinic of the Faculty Hospital Bratislava during the 18-year period from 1985 to 2003.


METHODS
59 patients were subject to surgical therapy by neurolysis, including 10 treatments of brachial plexus and 49 treatments of the upper limb nerves. The average age in the patient group was 35 years. The average period between the injury and surgical treatment was 6.9 months. Extremely long period over 12 months occurred in 3 cases. The treatment was performed in patients with complete or persisting neurological deficit. The external neurolysis was performed in 59 patients and this treatment was supplemented also by internal neurolysis in two cases. Cases requiring resection of fascicles and reconstruction with autotransplants and cases where reconstruction surgery has been already performed in the past have not been included into the study. The analysis of results was performed with respect to the period between the injury and operation, patient age, the type of injured nerve and the degree of fibrotic changes that have been identified peroperationally.


RESULTS
The evaluation of results has been performed according to Seddon classification (1975). The complete recovery of mobility, strength and BMG findings (classification grade M5) was observed in 25 patients. The functional grade M3 and more was present in 52 patients. The best results were observed in the youngest patient group aged below 20 years, in cases of early therapy onset, in patients with distal traumatic lesions and for neurolyses of n. radialis.


CONCLUSIONS
Based on our experience we believe that the early surgical revision is the critical factor determining the outcome of the operations in indicated cases. (Tab. 6, Ref. 3.)
Matejcik
V
V
Department of Neurosurgery, Faculty of Medicine, Comenius University, and University Hospital, Bratislava, Slovakia. bll@fmed.uniba.sk
Penzesova
G
G
D000328:Adult; D001132:Arm / Q000294:innervation*; D001917:Brachial Plexus / Q000293:injuries* / Q000601:surgery*; D006801:Humans; D059348:Peripheral Nerve Injuries; D010525:Peripheral Nerves / Q000601:surgery; D020127:Recovery of Function; D016896:Treatment Outcome