A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Anatomy

Background:

• The posterior subscapular approach provides good exposure for lower brachial plexus surgeries.
• This approach is utilized for complex cases like recurrent thoracic outlet syndrome, brachial plexus tumors, and post-radiation plexopathy.
• However, traditional methods involve extensive muscle dissection, leading to significant patient morbidity.

Observation:

• A modified posterior subscapular approach is presented.
• This technique employs a self-retaining retractor with partial dissection of the trapezius and rhomboid minor muscles.
• It aims to minimize the invasiveness of the traditional approach.

Findings:

• The modified approach maintains adequate exposure of the lower brachial plexus.
• It significantly reduces the extent of muscle dissection compared to the traditional method.
• This technique is associated with potentially lower postoperative morbidity.

Implications:

• This less invasive surgical technique may decrease patient recovery time.
• It offers a potentially safer alternative for brachial plexus surgeries.
• Further studies could validate reduced hospital stays and long-term outcomes.