Avulsion of the Brachial Plexus

Jaeger, Rudolph J.; Whiteley, W. H.

doi:10.1001/jama.1953.02940240025008

Cited by 25 publications

(3 citation statements)

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“…Further studies confirmed the value of cervical myelography in the diagnosis of root avulsion by comparison of myelogram with the findings from direct observation of the cervical spine after laminectomy. 18,28,29 On the basis of these studies, meningocele was considered as a pathognomonic sign of root avulsion. 30 However, it was noted that myelography does not always correlate with clinical picture and intraoperative findings.…”

Section: Discussionmentioning

confidence: 99%

“…These studies were focused on looking for traumatic meningoceles rather than an abnormality of the roots themselves. [18][19][20][21][22][23] An introduction of water-soluble contrast agents improved the quality of evaluation of the roots and the spinal cord. 24 Such investigation is better tolerated by the patients, can be performed earlier, and can be useful even in the presence of blood within the subarachnoid space.…”

Section: Mechanisms Of Nerve Roots Avulsionmentioning

confidence: 99%

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Radiological and Electrophysiological Detection of Nerve Roots Avulsion in Patients with Birth-Related Brachial Plexus Paralysis

Terzis¹,

Novikov²

2005

Seminars in Plastic Surgery

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The differential diagnosis between preganglionic and postganglionic lesions of the brachial plexus at the level of individual roots is critical. Preoperative neuroradiologic and electrophysiological studies are considered useful in detecting of root avulsions of the brachial plexus. In this study, the predictive value of plain cervical myelography, following computed tomography myelography (CTM) and preoperative electrodiagnostic evaluation, in detecting nerve root avulsions in cases of obstetrical brachial plexus paralysis was determined. The charts of 321 patients who had sustained brachial plexus paralysis and were operated on in our center from 1982 to 2003 were reviewed and analyzed. This study includes 70 cases of obstetrical brachial plexus palsy. Preoperative cervical myelography and CTM, as well as electrophysiological studies, were compared with final intraoperative diagnosis. A total of 420 spinal nerves were examined in 70 patients. Fifty-two patients (74.3%) had avulsion injury of brachial plexus. Intraoperatively, 135 roots (32.1%) were found to be avulsed. Accuracy, sensitivity, and specificity of preoperative plain myelography were 85.3%, 71.0%, and 92.3%; of CTM they were 89.4%, 83.2%, and 92.1%, respectively; and of electrodiagnostic studies they were 76.2%, 39.5%, and 93.2%, respectively. CTM and plain myelography were significantly more accurate and sensitive than electrophysiological studies (p < 0.05). There was no statistically significant difference in accuracy and sensitivity between plain myelography and CTM.

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Section: Discussionmentioning

confidence: 99%

Section: Mechanisms Of Nerve Roots Avulsionmentioning

confidence: 99%

Radiological and Electrophysiological Detection of Nerve Roots Avulsion in Patients with Birth-Related Brachial Plexus Paralysis

Terzis¹,

Novikov²

2005

Seminars in Plastic Surgery

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show abstract

“…Avulsion of the motor and sensory roots of the brachial plexus is a very severe lesion which cannot be repaired by means of classical techniques (Jaeger and Whiteley 1953;Mendelsohn et al 1957;. As it is impossible to reimplant the avulsed roots in the spinal cord, neurotization by means of foreign nerves is the only operation which can supply some innervation to the muscles and the skin depending on the brachial plexus (Alnot 1977;Millesi 1977).…”

Section: Discussionmentioning

confidence: 99%