Lukas Rasulić1,2, Andrija Savić3, Bojana Živković3, Filip Vitošević4, Mirko Mićović5,3, Vladimir Baščarević5,3, Vladimir Puzović6, Nenad Novaković7, Milan Lepić7, Miroslav Samardžić5,3, Stefan Mandić-Rajčević8. 1. Clinic for Neurosurgery, Clinical Center of Serbia, School of Medicine, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia. lukas.rasulic@gmail.com. 2. Department for Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia. lukas.rasulic@gmail.com. 3. Department for Peripheral Nerve Surgery, Functional Neurosurgery and Pain Management Surgery, Clinic for Neurosurgery, Clinical Center of Serbia, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia. 4. Clinic for Neurosurgery, Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia. 5. Clinic for Neurosurgery, Clinical Center of Serbia, School of Medicine, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia. 6. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. 7. Clinic for Neurosurgery, Military Medical Academy, Crnotravska 17, Belgrade, Serbia. 8. Innovation Centre of the Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, Belgrade, Serbia.
Abstract
BACKGROUND: The aim of this study was to investigate outcomes after surgery for brachial plexus injury (BPI), not only motor outcomes but also the quality of life of the patients. METHODS: We operated on 128 consecutive patients with BPI from 1992 to 2012. We documented the information on the injured nerve, level of injury, type of treatment used, timing of surgery, patient age, and preoperative and postoperative motor deficits. In 69 patients who agreed to participate in a quality of life study, additional assessments included functionality, pain, quality of life, patient satisfaction, and psychosocial health. RESULTS: Of patients who underwent only exploration and neurolysis, 35.3% showed a good quality of recovery. Patients who underwent nerve reconstruction using nerve grafting showed a better rate of good quality recovery (56.7%), and the results following nerve transfer depended on the type of transfer used. After surgery, 82.6% of patients showed significant improvement, 82.6% were satisfied, and 81.2% responded positively when asked if they would undergo surgery again if they knew the current result beforehand. Overall, 69.6% patients continued working after surgery. The mean DASH disability score was high (58.7) in the study group. Patients who had early surgery showed a consistently higher DASH score. About 76% of patients reported having pain regularly, and 18.8% reported depression or anxiety. CONCLUSIONS: We consider that it is important to report not only muscle recovery, but also other aspects of recovery.
BACKGROUND: The aim of this study was to investigate outcomes after surgery for brachial plexus injury (BPI), not only motor outcomes but also the quality of life of the patients. METHODS: We operated on 128 consecutive patients with BPI from 1992 to 2012. We documented the information on the injured nerve, level of injury, type of treatment used, timing of surgery, patient age, and preoperative and postoperative motor deficits. In 69 patients who agreed to participate in a quality of life study, additional assessments included functionality, pain, quality of life, patient satisfaction, and psychosocial health. RESULTS: Of patients who underwent only exploration and neurolysis, 35.3% showed a good quality of recovery. Patients who underwent nerve reconstruction using nerve grafting showed a better rate of good quality recovery (56.7%), and the results following nerve transfer depended on the type of transfer used. After surgery, 82.6% of patients showed significant improvement, 82.6% were satisfied, and 81.2% responded positively when asked if they would undergo surgery again if they knew the current result beforehand. Overall, 69.6% patients continued working after surgery. The mean DASH disability score was high (58.7) in the study group. Patients who had early surgery showed a consistently higher DASH score. About 76% of patients reported having pain regularly, and 18.8% reported depression or anxiety. CONCLUSIONS: We consider that it is important to report not only muscle recovery, but also other aspects of recovery.
Authors: Brandon W Smith; Kate W-C Chang; Serena J Saake; Lynda J-S Yang; Kevin C Chung; Susan H Brown Journal: Neurosurgery Date: 2019-09-01 Impact factor: 4.654
Authors: Thomas S Hong; Andrea Tian; Ryan Sachar; Wilson Z Ray; David M Brogan; Christopher J Dy Journal: J Bone Joint Surg Am Date: 2019-08-21 Impact factor: 5.284
Authors: Alexandra Bucknor; Anne Huang; Winona Wu; Aaron Fleishman; Sabine Egeler; Anmol Chattha; Samuel J Lin; Matthew L Iorio Journal: Plast Reconstr Surg Glob Open Date: 2019-02-05
Authors: Laura A Hruby; Clemens Gstoettner; Agnes Sturma; Stefan Salminger; Johannes A Mayer; Oskar C Aszmann Journal: J Clin Med Date: 2019-12-20 Impact factor: 4.241