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Outcome after brachial plexus injury surgery and impact on quality of life

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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.

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Author information

Authors and Affiliations

  1. Clinic for Neurosurgery, Clinical Center of Serbia, School of Medicine, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia

    Lukas Rasulić, Mirko Mićović, Vladimir Baščarević & Miroslav Samardžić

  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 Rasulić, Andrija Savić, Bojana Živković, Mirko Mićović, Vladimir Baščarević & Miroslav Samardžić

  3. Clinic for Neurosurgery, Neuroradiology Department, Center for Radiology and MRI, Clinical Center of Serbia, University of Belgrade, Dr Koste Todorovica 4, Belgrade, Serbia

    Filip Vitošević

  4. Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

    Vladimir Puzović

  5. Clinic for Neurosurgery, Military Medical Academy, Crnotravska 17, Belgrade, Serbia

    Nenad Novaković & Milan Lepić

  6. Innovation Centre of the Faculty of Technology and Metallurgy, University of Belgrade, Karnegijeva 4, Belgrade, Serbia

    Stefan Mandić-Rajčević

Authors
  1. Lukas Rasulić
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  2. Andrija Savić
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  3. Bojana Živković
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  4. Filip Vitošević
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  5. Mirko Mićović
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  6. Vladimir Baščarević
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  7. Vladimir Puzović
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  8. Nenad Novaković
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  9. Milan Lepić
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  10. Miroslav Samardžić
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  11. Stefan Mandić-Rajčević
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Corresponding author

Correspondence to Lukas Rasulić.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Comments

This study of patients at a single center undergoing brachial plexus surgery attempts to study not only recovery of motor function but also other important experiences of patients such as residual disability, satisfaction with the surgery, amount of residual pain, and willingness to undergo the surgery if the outcome is known. These are very important aspects to study, and this study represents an important step in this direction.

Michel Kliot

California, USA

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Rasulić, L., Savić, A., Živković, B. et al. Outcome after brachial plexus injury surgery and impact on quality of life. Acta Neurochir 159, 1257–1264 (2017). https://doi.org/10.1007/s00701-017-3205-1

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  • DOI: https://doi.org/10.1007/s00701-017-3205-1

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