Outcome of Nerve Grafting for Radiation-Induced Brachial Plexopathy.

Abstract

There is no consensus on the optimal treatment for radiation-induced brachial plexopathy (RIBP). To present our experience of using nerve resection and autografting as a treatment strategy for this challenging condition. From September 2014 to January 2020, 8 patients with RIBP were treated with segmental nerve resection and autografting, with or without other supplementary procedures. All patients underwent sural nerve grafting to the musculocutaneous nerve. All were female with a mean age of 53 (range 38-64) years. Seven were on the left, and 1 was on the right. The mean follow-up duration was 33 (range 17-72) months. By the final review, 7 of 8 patients regained at least antigravity elbow flexion. Four patients reached Medical Research Council (MRC) grade 4, 3 MRC grade 3, and MRC grade 2 recovery in the biceps. The mean Visual Analog Score for pain improved from 2.6 preoperatively to 0.6 postoperatively ( P = .042). Nerve resection and autografting may restore satisfactory elbow flexion in patients with RIBP.