Brachial Plexus Injury Treatment in New Jersey

The brachial plexus is a large, complex bundle of nerves in the shoulder. Nearly all signals that go from the brain to the upper arms and chest pass through the brachial plexus. An injury to the shoulder, neck, or arm can result in damage to the nerves of the brachial plexus, leading to loss of sensation, paralysis of the arm, or chronic pain.

Brachial plexus surgery can provide significant, long-term pain relief and restore functionality and movement. At The Institute for Advanced Reconstruction, our surgeons are highly skilled and experienced in many different methods of brachial plexus injury reconstruction.

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Causes of Brachial Plexus Injuries

The most common cause of brachial plexus injuries is trauma to the head/neck/shoulder, often in the form of a forceful widening between the head and shoulder. Damage can also be caused by tumor growth in the area, which places pressure on the brachial plexus nerves, or exposure to infectious agents, chemotherapy, or radiation from radiation therapy.

Symptoms of Brachial Plexus

The symptoms you experience with a brachial plexus injury will vary depending on the severity of the damage. Minor damage from the nerves being stretched or compressed can result in “burners” or “stingers,” which can feel like an electric shock or burning sensation along with numbness or weakness in the arm. These symptoms usually resolve within minutes, but they can linger for days or longer in some cases.

When the nerves are more severely damaged or even torn or ruptured, symptoms may include:

  • Weakness
  • Inability to move or use certain muscles in the hand, arm, or shoulder
  • Lack of feeling in the hand, arm, or shoulder
  • Severe pain

Diagnosing Brachial Plexus Injuries

Brachial plexus injuries can lead to permanent weakness or disability in your overall range of motion, so it’s important to understand what’s causing your symptoms. At The Institute for Advanced Reconstruction, treatment begins with a physical examination to assess your symptoms and understand what may have caused your injury. We may also perform diagnostic testing to gain more insight, which could include:

  • Ultrasound
  • X-ray
  • Nerve conduction study and Electromyography
  • MRI or CT Scan
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Treatment for Brachial Plexus Injuries

Brachial plexus injury pain can range from mild and fleeting to seriously debilitating. Depending upon the severity of your injury, treatments can span from physical therapy and medications that relieve inflammation to brachial plexus reconstruction surgery to relieve pressure on the nerves or even nerve replacement or rewiring.

We perform nerve grafting and nerve transfer surgery to help patients who have suffered massive injuries to the brachial plexus or other types of paralysis. Nerve grafting involves transferring a nerve from one place to another to replace a damaged segment, and nerve transfer surgery uses healthy nerves to “re-wire” the unhealthy nerves. In other words, taking a nerve from the general locale and using it within that locale without completely disconnecting it from its source.

In addition to nerve surgery, we also perform muscle transfers, tendon transfers, muscle flaps, and joint fusion to address paralysis and other symptoms.

Nerve Surgery: What to Expect

Nerve surgery can help patients regain sensation and functionality after serious brachial plexus injuries. We are proud to be one of the select practices with a surgical team in New Jersey that is specially trained to perform these complex procedures.

We offer several types of brachial plexus injury treatment surgeries. The best procedure for you will depend on many factors, including the extent of nerve damage, your symptoms, and your overall health.

  • Brachial plexus nerve repair: In some cases, when a nerve has been cut or torn, the surgeon may be able to sew the nerve back together using microscopic surgery. This is an ideal choice if the healthy nerve can be reconnected without tension after removing injured tissue. Once reconnected, the nerve will begin to regenerate and function will slowly return.
  • Brachial plexus decompression and neurolysis: When a nerve is compressed but still intact, symptoms can often be alleviated with decompression surgery. This procedure removes scar tissue or adhesions from the injured nerve using chemical or physical agents. Doing so provides space for the nerve to regenerate, reducing pain and improving function.
  • Nerve transfer surgery: Nerve transfer surgery involves taking a healthy nerve with a noncritical function and connecting it to the injured nerve, providing a new path for growth. This procedure often provides the best chance for regaining movement and sensation.
  • Nerve grafting surgery: Nerve grafting surgery bridges the gap between two ends of a damaged nerve using transplanted sensory nerve tissue. We harvest the donor nerve from an area of your body where sensation is not vital, often from the sural nerve in the back of the leg or the medial and lateral antebrachial cutaneous nerves in the arm.

What to expect with brachial plexus surgery
The specific steps involved will depend on the type of procedure you choose. In general, your surgery will include the following:

  • We will place you under general anesthesia.
  • For nerve grafting surgery, the surgeon will begin with removing the donor nerve through tiny, precise incisions.
  • The surgeon will make an incision near your injured nerve.
  • Any damaged or scarred tissue will be removed.
  • Using microscopic surgery, we will reconnect, reroute, or graft healthy nerve tissue to improve function.

Recovery and expected outcome
Most patients are able to go home either the same day or within a few days of having brachial plexus nerve surgery, depending on the complexity of the surgery. We may ask you to wear a splint or sling for a couple of weeks.

Many factors can affect your total recovery time and expected outcome — including your age, the severity of your injury, your dedication to therapy, and more. As nerve fibers grow slowly (about an inch per month), regaining sensation and functionality will take time. Physical and occupational therapy will play a crucial role in your recovery process.

About Us

When patients run out of options,

We provide a new pathway that offers hope and relief.

At The Institute for Advanced Reconstruction, we have an entire surgical team dedicated to performing complex brachial and peripheral nerve procedures. Our reconstructive surgeons are among the few doctors in the world with the specialized training and experience to perform advanced nerve reconstruction surgery.

Using a true team approach to care is the hallmark of our practice and the best way to integrate an overall care plan for the patient. We explore every available treatment and procedure and will not quit until we’ve exhausted every possibility. Very few institutions use this approach for brachial plexus and peripheral nerve surgery procedures. We are proud to be one of them.

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Brachial Plexus FAQs

Q: What is the brachial plexus?

Brachial means “arm” and plexus means “communication” or “meeting point”. In medical terms, the brachial plexus refers to the nerves that exit the cervical spine and pass down to the shoulder and arm. This network of nerves is responsible for delivering communication signals between the spinal cord and the shoulder, arm, and hand. When those nerves are damaged, we refer to the condition as a brachial plexus injury.

Q: Are brachial plexus injuries common?

We often see these injuries in adults – mostly due to trauma. However, there are other injuries similar to, but not necessarily to, the brachial plexus. Brachial plexus is the procedure for which we have received the most attention, but we focus on all peripheral nerve injuries—from the face down to the toes.

Q: What procedures are offered at The Institute for Advanced Reconstruction for brachial plexus injuries?

Depending upon the seriousness of the injury, treatments for brachial plexus injury range from a “wait and see approach” with physical therapy to complex surgical reconstruction. We perform nerve grafting and nerve transfer surgery to help patients who have suffered massive injuries to the brachial plexus or other types of paralysis.

Q: Can anyone qualify for nerve surgery?

A patient’s surgical treatment regimen needs to be personalized, as it is often a complex, multi-step undertaking. Some patients are not candidates for nerve surgery, and some patients gain the maximum benefits from nerve surgery. If you are not a candidate for nerve surgery, there are many other procedures that can be undertaken to help manage symptoms. Muscle transfers, tendon transfers, muscle flaps, and joint fusion are just a few of the procedures that we perform to benefit patients with paralysis who do not qualify for nerve surgery.

Q: Will I need to have multiple surgeries?

With severe brachial plexus injuries, additional nerve surgeries are often necessary. We may perform muscle transfers, tendon transfers, muscle flaps, and joint fusions in future surgeries. In the majority of cases, we have to go beyond the first and most obvious step to ensure the best possible results. One procedure may result in improvements, but to maximize those results, a patient often requires a multi-faceted approach.

Q: How do you define a successful outcome?

We measure success by how happy patients are after surgery. The factors that often determine patient satisfaction are:

  • Reducing or eliminating the need for pain narcotics
  • Improving movement and mobility
  • Improving overall quality of life

Q: What sets you apart in your approach to brachial plexus surgery?

From the least to most complicated cases, our surgeons are dedicated to returning patients to the best quality of life possible. We particularly pride ourselves in caring for patients who have been told that nothing can be done, or that they have maximized their treatment. Our surgical training can take them to the next level. We rarely see someone and say there is nothing we can do. We’re going to get them better than they were—that’s our obsession, just ask our patients.

More Information

Contact us to learn more about brachial plexus injuries.

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