Motor Recovery after Surgical Neurolysis in Brachial Plexus Neuropathy: A Case series and Systematic Review

Abstract

Surgical neurolysis is a procedure designed to liberate an injured nerve from scar tissue or adjacent structure, thereby facilitating nerve regeneration in cases of brachial plexus neuropathy (BPN). This study presents a case series of patients diagnosed with BPN who underwent surgical neurolysis. The primary focus was on the clinical assessment of recovery using the British Medical Research Council motor grading scale (BMRC). Additionally, a comprehensive literature review was conducted to analyze motor recovery outcomes related to surgical neurolysis for BPN. 18 patients with BPN who underwent surgical neurolysis where included. The results experienced a notable increase of 58% in muscle strength as assessed by the BMRC. The average preoperative state of 2.17±1.15 improved significantly to a postoperative condition of 3.44±1.34 (p = 0.003, d= 0.913) The systematic review identified 2298 articles which were selected for qualitative analysis, demonstrated that surgical neurolysis was associated with favorable motor recovery outcomes in 75.82% of the patients. Both the case series and the literature review reveal significant motor recovery following surgical neurolysis. It is crucial to conduct well-designed, adequately powered, randomized, and blinded clinical trials. Such studies will provide robust evidence to support or refute the utility of this approach in motor recovery.