Ultrasound of the cervical roots and brachial plexus in neonates

Abstract

Ultrasound of the neonatal cervical nerve roots is feasible and may be used as a non-invasive screening technique to assess nerve root integrity in obstetric brachial plexus injury.

Ultrasound of cervical roots and brachial plexus in neonates

“…We would like to commend Pillen et al for their publication on the use of ultrasound in healthy neonates. We have been using ultrasound for 2 years in infants undergoing brachial plexus reconstruction following birth‐related brachial plexus injury in an attempt to determine its clinical utility in presurgical planning.…”

Assessment of obstetric brachial plexus injury with preoperative ultrasound

“…In a recent US study in normal neonates, relatively large amounts of brown fat were observed, which produces a US image of the brachial plexus distinct from that seen in older age groups. 12 In our cohort we did not appreciate large amounts of brown fat, and we do not believe that our ability to insonate components of the plexus was hindered. In addition, we did not experience difficulty with identification of neural components in the interscalene region in our patients, a potential concern raised by the same authors.…”

“…Although MRI is less operator‐dependent than US, accuracy of radiographic interpretation is also subject to a learning curve on the part of the interpreter and is subject to other confounders, such as patient movement, variability in MRI scanners, and changing scanning technology. In a recent US study in normal neonates, relatively large amounts of brown fat were observed, which produces a US image of the brachial plexus distinct from that seen in older age groups . In our cohort we did not appreciate large amounts of brown fat, and we do not believe that our ability to insonate components of the plexus was hindered.…”

“…In our cohort we did not appreciate large amounts of brown fat, and we do not believe that our ability to insonate components of the plexus was hindered. In addition, we did not experience difficulty with identification of neural components in the interscalene region in our patients, a potential concern raised by the same authors …”

Current Approach to Obstetric Brachial Plexus Palsy

“…In addition, an excess of browncolored fat tissue leads to a different appearance. Consequently, there has been increased use in recent years of US as a non-invasive imaging technique to visualize cervical roots in the [5,6]. Even though it is initially difficult to see the brachial plexus on US, it is an examination which is easy to apply, very quickly and provides theoretical experience.…”