Intraoperative testing and monitoring during brachial plexus surgery

Abstract

Publisher Summary This chapter reviews that operative assessment and intervention for brachial plexus pathology can be optimized by intraoperative electrophysiological techniques. These techniques may be used in the surgery of the brachial plexus or its terminal branches whether for injury, entrapment, or tumor. It discusses that in cases of injury, intraoperative electrophysiological testing allows surgeons to better judge the function of the nerve, the severity of the injury, and the potential for neural recovery. The intraoperative testing helps determine the severity of compression as well as assisting in the avoidance of accidental injury to neighboring nerves. The chapter reviews that it can also assist the surgeon to preserve critical nerve function when resecting a tumor and help select nonfunctional fascicles when a nerve biopsy is needed. It explores that these studies are helpful to preserve the critical functions in incomplete injuries or lesions requiring exploration, nerve biopsy, or tumor resection. Finally, they are helpful in appropriate fascicle selection when intra or extraplexal nerve transfers are used for the reanimation of paralyzed muscle.