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Contralateral brachial plexus neuropathy after arthroscopic shoulder surgery.
Attila Pavlik1, Kian C Ang, Simon N Bell
1Department for Sports Surgery, National Institute for Sports Medicine, Budapest, Hungary.
Summary
A rare neurologic complication, brachial plexus palsy, occurred after shoulder surgery due to an unknown cervical rib and patient positioning. This reversible C7-T1 lesion resolved within 3 months, highlighting the need for careful patient positioning.
Area of Science:
- Neurology
- Orthopedic Surgery
- Anatomy
Background:
- Shoulder arthroscopic surgery is a common orthopedic procedure.
- Neurologic complications, though rare, can occur.
- Patient positioning is critical during surgical procedures.
Observation:
- A patient developed brachial plexus palsy after contralateral shoulder arthroscopic surgery.
- The palsy was identified as a reversible C7-T1 lesion.
- An unknown cervical rib was identified as a contributing factor.
Findings:
- The neurologic complication was directly linked to the patient's specific anatomic variant (cervical rib) and the lateral decubitus position used during surgery.
- The brachial plexus palsy demonstrated a reversible C7-T1 lesion.
- Complete recovery was observed within three months post-surgery.
Implications:
- Highlights the importance of identifying pre-existing anatomic variants, such as cervical ribs, before surgery.
- Emphasizes the need for meticulous patient positioning protocols in orthopedic surgery to prevent iatrogenic nerve injuries.
- Suggests that awareness and prevention strategies can mitigate the risk of brachial plexus palsy in susceptible patients.