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Patient satisfaction and disability after brachial plexus surgery.

Thomas Kretschmer1, Sarah Ihle, Gregor Antoniadis

  • 1Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Günzburg, Günzburg, Germany. thomas.kretschmer@uni-ulm.de

Neurosurgery
|November 21, 2009
PubMed
Summary

Most patients are satisfied and would repeat brachial plexus surgery. However, significant disability persists, and return to work is challenging, though occupational retraining shows success.

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Patient Outcomes

Background:

  • Brachial plexus surgery outcomes, including patient satisfaction and disability, are not well-documented.
  • Understanding patient perspectives is crucial for evaluating surgical success.

Purpose of the Study:

  • To assess patient satisfaction and disability after brachial plexus surgery.
  • To determine if patients would opt for the procedure again given the outcomes.
  • To evaluate self-rated results and functional limitations.

Main Methods:

  • A cohort of 319 patients who underwent brachial plexus surgery between 1995 and 2005 were surveyed.
  • A 65-item questionnaire, including the Ulm Questionnaire and the Disability of the Arm, Shoulder, and Hand (DASH) score, was administered.
  • Data from 70 returned questionnaires were analyzed.

Main Results:

  • Overall, 87% of patients were satisfied and 83% would undergo the surgery again.
  • Mean DASH scores indicated significant disability (overall mean 52).
  • Pain, back pain, and psychological distress were prevalent. Return to work was challenging, with 52% of previous workers remaining unemployed, though occupational retraining was successful for 70%.

Conclusions:

  • Brachial plexus surgery yields high patient satisfaction and willingness to repeat the procedure.
  • Despite satisfaction, considerable long-term disability and challenges in returning to work persist.
  • Occupational retraining programs are effective in improving vocational outcomes for affected patients.