Posterior subscapular approach to the brachial plexus.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Anatomy

Background:

• The brachial plexus is crucial for arm and hand function.
• Neural entrapment and spinal nerve injuries pose significant clinical challenges.
• Certain patient factors, like prior neck surgery or obesity, complicate surgical access.

Purpose of the Study:

• To describe the anatomy and operative technique of the posterior subscapular approach to the brachial plexus.
• To highlight the indications for this surgical approach.

Main Methods:

• Detailed anatomical description of the posterior subscapular region relevant to brachial plexus access.
• Step-by-step operative technique for the posterior subscapular approach.
• Review of clinical cases and indications over 25 years.

Main Results:

• The posterior subscapular approach provides effective access to the brachial plexus.
• This approach is suitable for specific conditions including neurogenic thoracic outlet syndrome, paraspinal tumors, and spinal nerve injuries.
• It is advantageous in patients with previous anterior neck operations or morbid obesity.

Conclusions:

• The posterior subscapular approach is a valuable surgical option for brachial plexus pathologies.
• Understanding the detailed anatomy is key to successful application of this technique.
• This approach offers a viable alternative when anterior approaches are contraindicated or less suitable.