Post-surgical Brachial Plexopathy

Postoperative brachial plexopathy is a rare but recognized complication of cervical spine surgery, typically resulting from intraoperative traction, positioning, or compression of the brachial plexus. We present the case of a man in his 50s with poorly controlled diabetes who developed acute, severe upper-extremity pain, weakness, and numbness two days after a multilevel anterior cervical discectomy and fusion for cervical stenosis. Examination revealed C5-C6 deficits, and electromyography demonstrated active denervation in multiple muscles innervated by these roots. Magnetic resonance imaging (MRI) of the brachial plexus showed mild edema, while shoulder imaging revealed extensive rotator-cuff pathology. This case underscores the diagnostic challenge of distinguishing postoperative brachial plexopathy from simultaneous musculoskeletal disease and highlights the importance of early electrodiagnostic testing, careful imaging assessment, and timely management in high-risk patients.