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Preoperative electrophysiological evaluation and postoperative clinical and functional outcomes in brachial plexus injury after surgical neurolysis

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Jun 13, 2021 version files 13.57 KB

Abstract

Introduction/Aims: Electrophysiological and clinical Correlation of pre- and post-operative analysis in BPI surgical management through the use of Neurolysis.

Methods: An ambilective quasi-experimental analytical study was carried out. In order to determine the prognostic value of the preoperative electrophysiological analysis in the clinical and functional recovery after surgical intervention. the study was approved by the Hospital's research and bioethics committee (DI/16/403/03/152), the informed consents were obtained and signed by all the patients included. A Wilcoxon test was performed in search of significant clinical and functional changes after surgery, and a Spearman Correlation test was realized between the preoperative electrophysiological variables and postoperative clinical and functional outcomes. Value α = 0.05 and β = 0.01.

Results: Twenty patients were studied. Postoperative clinical evaluation showed significant changes in terms of pain (∆79.95%, p = 0.034), upper limb functional recovery (∆31.53%, p = 0.029), and subjective perception of general health (∆15.83%, p = 0.007). Correlation analysis showed that the stronger relationship was observed in the association between fibrillation potentials with the recovery of postoperative pain (R = 0.997, p = <0.001), polyphasic units with the increase in the patient's subjective perception of their general health measured (R = 0.999, p <0.001), and the amplitude of the sensitive nerve action potential with sensorial recovery (R = 0.942, p = 0.009).

Discussion/Conclusion: Neurolysis demonstrated changes in pain and functional recovery, related to the presence of polyphasic units and fibrillation potentials. The prognostic value of electrophysiology in postoperative clinical recovery is uncertain, this study introduces the possibility of observing preoperative electrophysiological studies as a prognostic tool for clinical and functional recovery in the surgical management of BPI.