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Brachial Plexus Surgery

The brachial plexus is a group of 5 nerves that emerge from the neck and join together to form a network that supplies the arm. There are many conditions that can affect the brachial plexus including compression, tumour formation and injury. Such problems with the nerves are often referred to as lesions, and a lesion of the plexus can result in pain, altered sensation, loss of sensation, weakness or paralysis of some or all of the muscles of the arm. Many of these conditions are treatable provided they are seen early enough. If you have been diagnosed with a brachial plexus injury, a tumour of the plexus or have thoracic outlet symptoms (compression affecting the brachial plexus) then early intervention is recommended.

Frequently asked questions

How are brachial plexus lesions diagnosed?

Damage to the brachial pleuxs is diagnosed by taking the history of the complaint (telling Mr. MacQuillan during your consultation what the problems are that you are currently experiencing with your arm), clinical examination and then specialist investigations as directed by the examination findings. The specialist tests most frequently requested include MRI scans, ultrasound scans and nerve conduction studies (looking how well the nerves are conducting electrical impulses and how healthy the muscles are). If the worry is that you have developed a growth in your brachial plexus a tissue sample (biopsy) may often need to be obtained in order to make a definitive diagnosis prior to any surgery.

Is surgery always necessary?

Often surgery is not necessary. Many injuries recover by themselves, and compression syndromes frequently respond to physiotherapy. The decision to operate or not is a joint one based on your wishes and the treatments that you have had or not had previously. Mr. MacQuillan will give you all treatment options and the pro’s and con’s of each. All of the potential risks of surgery will be discussed and you will have the opportunity to ask as many questions as you wish.

What does brachial plexus surgery involve?

Depending on where the lesion to the brachial plexus is, the timing of the surgery (is it soon after the initial problem occurred or is it now many months down the line?) and the severity of the problem, the surgery can involve one or more incisions. The initial incision is usually either at the base of the neck or just in front of the shoulder. Depending on what the problem is further incisions may be necessary. Mr. MacQuillan will go through all the possibilities with you regarding potential incisions during your consultation. A brief video describing the incisions commonly used will be available in the panel below in the near future and this will take you through how the brachial plexus is exposed during surgery (if you are not keen on the sight of blood however, don’t worry it is an animated video with no real blood in it!).

How long will I be in hospital?

For most brachial plexus operations you will only need to stay in hospital one or two nights at most. For more complex reconstructions involving muscles being moved from one part of the body to another, or if the nerves from the chest are needed to provide a new source of electricity to the muscles in the arm, then this may be increased to up to a week.

What else do I need to know?

Depending on what the lesion is to the brachial plexus is there will be additional information available on the web site to explain what happens during the surgery (the links below will become live once the content is available):

  • Nerve tumours
  • Thoracic outlet syndrome (compression of the nerves of the brachial plexus)
  • Nerve transfers (usually done after traumatic injury to the plexus)
  • Nerve grafting (usually done after traumatic injury to the plexus)
  • Neurolysis
  • Free functional muscle transfer (usually done after traumatic injury to the plexus)

Brachial plexus introduction