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[Actinic brachial plexus lesion]

G Tairych1, B Todoroff, R Sedivy

  • 1Universitätsklinik für Chirurgie, Klinische Abteilung für Wiederherstellende und Plastische Chirurgie, Wien.

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|September 25, 1998
PubMed
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Radiation-induced brachial plexus lesions often cause irreversible damage. Surgical interventions like neurolysis with tissue flaps may relieve pain but do not restore nerve function.

Area of Science:

  • Neurology
  • Surgical Oncology
  • Radiation Oncology

Context:

  • Radiation-induced brachial plexopathy is a progressive and irreversible complication.
  • Current treatment options for radiation-induced brachial plexus lesions are limited, with no established methods for prevention or successful treatment.
  • Neurolysis has shown potential for pain relief but not for functional recovery.

Purpose:

  • To evaluate the efficacy of neurolysis combined with muscle or gliding tissue flaps in improving vascularity and nerve tissue regeneration for radiation-induced brachial plexopathy.
  • To assess the impact of surgical interventions on pain, sensory, and motor function in patients with radiation-induced brachial plexus lesions.

Summary:

  • A series of 25 patients with radiation-induced plexopathy treated since 1975 were reviewed, with 18 patients followed for surgical intervention outcomes.

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  • Neurolysis, with or without muscle or gliding tissue flaps, was performed to improve nerve regeneration and vascularity.
  • None of the 18 evaluated patients experienced improvement in sensory or motor function. Severe pain relief was achieved in 83% of patients. Postoperative worsening of paresis and return of severe pain were observed in some cases.

    • Impact:

    • Surgical intervention, including neurolysis and tissue flaps, can provide significant pain relief for radiation-induced brachial plexopathy in a majority of patients.
    • The study indicates that current surgical approaches do not restore lost sensory or motor function and may carry risks of functional decline or pain recurrence.
    • Findings highlight the need for further research into effective treatments for radiation-induced brachial plexus lesions, focusing on functional recovery and long-term pain management.