Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press9510.17650/2222-8721-2012-0-4-19-27LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫTraumatic brachial plexus injuries and current surgical correction methods Part I. Diagnosis of Traumatic brachial plexus injuryТравматические повреждения плечевого сплетения и современные способы хирургической коррекции Часть I. Диагностика повреждений плечевого сплетенияNovikovM. L.НовиковМ. Л.
Russian Federation
novik6923@gmail.comN.V. Solovyev Clinical Hospital for Emergency Medical Care, YaroslavlКлиническая больница скорой медицинской помощи им. Н.В.Соловьева, Ярославль211120122419272102201521022015Copyright ©; 2012, Novikov M.L.Copyright ©; 2012, Новиков М.Л.2012Novikov M.L.Новиков М.Л.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/95

The task of this paper is to familiarize practicing neurologists, neurosurgeons, traumatologists, and orthopedists with the current principles of diagnosis and treatment of different brachial plexus injuries (BPI). The anatomy of the brachial plexus is described in detail; the main mechanisms of its injuries are considered and their current classification is given. Particular emphasis is laid on the traction-based mechanism of BPI and its basic treatment in a group of patients who require (need) surgical treatment. The capabilities of various instrumental techniques, such as X-ray, neuroimaging, electrophysiological, in the diagnosis of BPI are considered. The author’s algorithm for a differential diagnostic search is proposed in this pathology.

Задача настоящей публикации – познакомить практикующих неврологов, нейрохирургов, травматологов и ортопедов с современными принципами диагностики и лечения различных повреждений плечевого сплетения (ППС). Подробно описана анатомия плечевого сплетения, рассматриваются основные механизмы его повреждения, дается их современная классификация. Особое внимание уделено тракционному механизму ППС, как наиболее сложному и часто встречающемуся и основному в группе пациентов, нуждающихся в оперативном лечении. Рассматриваются возможности различных инструментальных методов – рентгенологических, нейровизуализационных, электрофизиологических – в диагностике ППС. Предлагаетсяавторский алгоритм дифференциально-диагностического поиска при данной патологии.

brachial plexusspinal nervesmyographymyelographyплечевое сплетениеспинномозговые нервымиографиямиелография1. Narakas A. Brachial plexus surgery. Orthop Clin North Am 1981;12:303–23.Narakas A. Brachial plexus surgery. Orthop Clin North Am 1981;12:303–23.2. Millesi H. Brachial plexus injuries: management and results. In: Terzis J.K., ed. Microreconstruction of nerve injuries. Philadelphia: WB Saunders, 1987:247–260.Millesi H. Brachial plexus injuries: management and results. In: Terzis J.K., ed. Microreconstruction of nerve injuries. Philadelphia: WB Saunders, 1987:247–260.3. Terzis J.K., Papakonstantinou K.C. The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg 2000;106:1097–118.Terzis J.K., Papakonstantinou K.C. The surgical treatment of brachial plexus injuries in adults. Plast Reconstr Surg 2000;106:1097–118.4. Songcharoen P. Brachial plexus injury in Thailand: a report of 520 cases. Microsurgery 1995;16:35–9.Songcharoen P. Brachial plexus injury in Thailand: a report of 520 cases. Microsurgery 1995;16:35–9.5. Jennifer L. Giuffre, Sanjiv Kakar, Allen T. Bishop et al. Current concepts of the treatment of adult brachial plexus injuries. J Hand Surg 2010;35(4):678–88.Jennifer L. Giuffre, Sanjiv Kakar, Allen T. Bishop et al. Current concepts of the treatment of adult brachial plexus injuries. J Hand Surg 2010;35(4):678–88.6. Leffert R.D. Brachial plexus. In: Green DP (ed.). Operative hand surgery, ed. 2nd. Churchill Livingstone, 1988. P. 1091–1108.Leffert R.D. Brachial plexus. In: Green DP (ed.). Operative hand surgery, ed. 2nd. Churchill Livingstone, 1988. P. 1091–1108.7. Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain, 1951.Sunderland S. A classification of peripheral nerve injuries producing loss of function. Brain, 1951.8. Tubiana R. Clinical examination and functional assessment of the upper limb after peripheral nerve lesions. In: Tubiana R., ed. The hand. Philadelphia: WB Saunders, 1988.Tubiana R. Clinical examination and functional assessment of the upper limb after peripheral nerve lesions. In: Tubiana R., ed. The hand. Philadelphia: WB Saunders, 1988.9. Aids to the examination of the peripheral nervous system. 4-th edition. London: Elsevier Saunders, 2000.Aids to the examination of the peripheral nervous system. 4-th edition. London: Elsevier Saunders, 2000.10. Sloof A.C., Versteege C.W., Blaauw G. et al. Radiological and related investigations. In: Gilbert A. (ed.). Brachial plexus injuries. Martin Dunitz, 2001. P. 31–37.Sloof A.C., Versteege C.W., Blaauw G. et al. Radiological and related investigations. In: Gilbert A. (ed.). Brachial plexus injuries. Martin Dunitz, 2001. P. 31–37.11. Murphey F., Hartung W., Kirklin J.W. Myelographic demonstration of avulsing injury of the brachial plexus. AJR Am J Roentgenol 1947;58:102–5.Murphey F., Hartung W., Kirklin J.W. Myelographic demonstration of avulsing injury of the brachial plexus. AJR Am J Roentgenol 1947;58:102–5.12. Nagano A., Ochiai N., Sugioka H. et al. Usefulness of myelography in brachial plexus injuries. J Hand Surg [Br] 1989;14:59–64.Nagano A., Ochiai N., Sugioka H. et al. Usefulness of myelography in brachial plexus injuries. J Hand Surg [Br] 1989;14:59–64.13. Marshall R.W., De Silva R.D.D. Computerized axial tomography in traction injuries of the brachial plexus. J Bone Joint Surg Br 1986;68:734–8.Marshall R.W., De Silva R.D.D. Computerized axial tomography in traction injuries of the brachial plexus. J Bone Joint Surg Br 1986;68:734–8.14. Cobby M.J.D., Leslie I.J., Watt I. Cervical myelography of nerve root avulsioninjuries using water-soluble contrast media. Br J Radiol 1988;61:673–8.Cobby M.J.D., Leslie I.J., Watt I. Cervical myelography of nerve root avulsioninjuries using water-soluble contrast media. Br J Radiol 1988;61:673–8.15. Ochi M., Ikuta Y., Watanabe M. et al. The diagnostic value of MRI in traumatic brachial plexus injury. J Hand Surg [Br] 1994;19:55–9.Ochi M., Ikuta Y., Watanabe M. et al. The diagnostic value of MRI in traumatic brachial plexus injury. J Hand Surg [Br] 1994;19:55–9.16. Sureka J., Cherian R.A., Alexander M. et al. MRI of brachial plexopathies. Clin Radiol 2009;64:208–18.Sureka J., Cherian R.A., Alexander M. et al. MRI of brachial plexopathies. Clin Radiol 2009;64:208–18.17. Tagliafico A., Succio G., Neumaier C.E. et al. MR imaging of the brachial plexus: comparison between 1.5-T and 3-T MR imaging: preliminary experience. SkeletalRadiol 2010;40(6):717–24.Tagliafico A., Succio G., Neumaier C.E. et al. MR imaging of the brachial plexus: comparison between 1.5-T and 3-T MR imaging: preliminary experience. SkeletalRadiol 2010;40(6):717–24.18. Rapoport S., Blair D.N., McCarthy S.M. et al. Brachial plexus: correlation of MR imaging with CT and pathologic findings. Radiology 1988;167:161–5.Rapoport S., Blair D.N., McCarthy S.M. et al. Brachial plexus: correlation of MR imaging with CT and pathologic findings. Radiology 1988;167:161–5.19. Doi K., Otsuka K., Okamoto Y. et al. Cervical nerve root avulsion in brachial plexus injuries: magnetic resonance imaging classification and comparison with myelography and computerized tomography myelography. J Neurosurg 2002; 96(Suppl. 3):277–84.Doi K., Otsuka K., Okamoto Y. et al. Cervical nerve root avulsion in brachial plexus injuries: magnetic resonance imaging classification and comparison with myelography and computerized tomography myelography. J Neurosurg 2002; 96(Suppl. 3):277–84.20. Shafighi M., Gurunluoglu R., Ninkovic M. et al. Ultrasonography for depiction of brachial plexus injury.Shafighi M., Gurunluoglu R., Ninkovic M. et al. Ultrasonography for depiction of brachial plexus injury.J Ultrasound Med 2003;22:631–4.21. Martinoli C., Bianchi S., Santacroce E. et al. Brachial plexus sonography: a technique for assessing the root level. AJR Am J Roentgenol 2002;179:699–702.Martinoli C., Bianchi S., Santacroce E. et al. Brachial plexus sonography: a technique for assessing the root level. AJR Am J Roentgenol 2002;179:699–702.22. Bufalini C., Pescatori G. Posterior cervical electromyelography in the diagnosis and prognosis of brachial plexus injuries. Bone Joint Surg 1969;1B:627–31.Bufalini C., Pescatori G. Posterior cervical electromyelography in the diagnosis and prognosis of brachial plexus injuries. Bone Joint Surg 1969;1B:627–31.23. Leffert R.D. Clinical diagnosis, testing, and electromyographic study in brachial plexus traction injuries. CORR 1988;237:24–31.Leffert R.D. Clinical diagnosis, testing, and electromyographic study in brachial plexus traction injuries. CORR 1988;237:24–31.24. Balakrishnan G., Kadadi B.K. Clinical examination versus routine and paraspinal electromyographic studies in predicting the site of lesion in brachial plexus injury. J Hand Surg Am 2004;29(1):140–3.Balakrishnan G., Kadadi B.K. Clinical examination versus routine and paraspinal electromyographic studies in predicting the site of lesion in brachial plexus injury. J Hand Surg Am 2004;29(1):140–3.