The applied motor evoked potential methods seem to improve long-term motor outcome significantly. Early motor outcome is similar because of transient motor deficits in the INM group, which can be predicted at the end of surgery by the neurophysiological profile of patients.
This report aims to present the guidelines of management and repair strategy in the surgical treatment of brachial plexus injuries (BPI) according to the Authors' experience, by analyzing a surgical series of 428 supraclavicular lesions. Methods From April 1990 to June 2013 the Authors have operated 578 posttraumatic BPI in adults: 428 supraclavicular and 150 infraclavicular injuries. Supraclavicular lesions have been retrospectively reviewed, focusing on the diagnostic assessment, the timing of surgery, the surgical findings, the repair strategies and their outcome. Infraclavicular injuries have been excluded from this study due to their higher variability in findings, with consequent lack of homogeneity in outcome. Preoperative assessment Patients were evaluated clinically (Figure 1) and by neuroradiological (MyeloCT or MR Myelography) (Figure 2) and electrodiagnostic studies (EDS). Imaging studies are preferably indicated after 3-4 weeks from the causative event due to the fact that pseudomeningoceles need a few weeks to form [1,2].
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