Pain from the most severe types of brachial plexus injuries has been described as a debilitating, severe crushing sensation or a constant burning. Muscle transfer is a procedure in which your surgeon removes a less important muscle or tendon from another part of the body, typically the thigh, transfers it to the arm, and reconnects the nerves and blood vessels supplying the muscle. This provides a bypass for new nerve growth. When the nerve root has been torn from the spinal cord, surgeons often take a less important nerve that's still working and connect it to a nerve that's more important but not working. This provides a bridge for new nerve growth over time. In this procedure, the damaged part of the brachial plexus is removed and replaced with sections of nerves taken from other parts of the body. This procedure consists of freeing up the nerve from scar tissue. This skin flap can help the surgeons monitor whether the muscle is getting enough blood after it has been transferred to its new location. A section of skin and tissue attached to the donor muscle may also be removed. The most commonly used donor muscle is in the inner thigh. If the arm muscles have atrophied from lack of use, a muscle transfer may be needed. This test is sometimes performed when MRIs don't provide adequate information. CT myelography adds a contrast material, injected during a spinal tap, to produce a detailed picture of the spinal cord and nerve roots during a CT scan. Computerized tomography uses a series of X-rays to obtain cross-sectional images of the body.
New methods of high-resolution MRI, known as magnetic resonance neurography, may be used. It often can show the extent of the damage caused by a brachial plexus injury and can help assess the status of arteries that are important for the limb or for its reconstruction. This test uses a powerful magnetic field and radio waves to produce detailed views of the body in multiple planes. This provides information about how well the nerve is functioning. These tests are usually performed as part of the EMG, and they measure the speed of conduction in the nerve when a small current passes through the nerve.
You may feel a little pain when the electrodes are inserted, but most people can complete the test without much discomfort. The test evaluates the electrical activity of the muscles when they contract and when they're at rest. During an EMG, your provider inserts a needle electrode through the skin into various muscles. An X-ray of the shoulder and neck can tell the provider if you have fractures or other associated injuries. To help diagnose the extent and severity of a brachial plexus injury, you may have one or more of the following tests: To diagnose your condition, your provider will review your symptoms and conduct a physical examination.
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