CC-BY 4.0 · J Brachial Plex Peripher Nerve Inj 2017; 12(01): e7-e14
DOI: 10.1055/s-0037-1606841
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Current Concept in Adult Peripheral Nerve and Brachial Plexus Surgery

Lukas Rasulic1, 2
  • 1School of Medicine, University of Belgrade, Belgrade, Serbia
  • 2Clinic for Neurosurgery, Clinical Center of Serbia, Belgrade, Serbia
Further Information

Publication History

01 February 2016

24 July 2017

Publication Date:
02 October 2017 (online)

Abstract

Peripheral nerve injuries and brachial plexus injuries are relatively frequent. Significance of these injuries lies in the fact that the majority of patients with these types of injuries constitute working population. Since these injuries may create disability, they present substantial socioeconomic problem nowadays. This article will present current state-of-the-art achievements of minimal invasive brachial plexus and peripheral nerve surgery. It is considered that the age of the patient, the mechanism of the injury, and the associated vascular and soft-tissue injuries are factors that primarily influence the extent of recovery of the injured nerve. The majority of patients are treated using classical open surgical approach. However, new minimally invasive open and endoscopic approaches are being developed in recent years—endoscopic carpal and cubital tunnel release, targeted minimally invasive approaches in brachial plexus surgery, endoscopic single-incision sural nerve harvesting, and there were even attempts to perform endoscopic brachial plexus surgery. The use of the commercially available nerve conduits for bridging short nerve gap has shown promising results. Multidisciplinary approach individually designed for every patient is of the utmost importance for the successful treatment of these injuries. In the future, integration of biology and nanotechnology may fabricate a new generation of nerve conduits that will allow nerve regeneration over longer nerve gaps and start new chapter in peripheral nerve surgery.