Brachial plexus injury following spinal surgery

Object. In the present study, the authors identified the etiology, precipitating factors, and outcomes of perioperative brachial plexus injuries following spine surgery. Methods. We reviewed all the available literature regarding postoperative/perioperative brachial plexus injuries, with special concern for the patient's position during surgery, duration of surgery, the procedure performed, neurological outcome, and prognosis. We also reviewed the utility of intraoperative electrophysiological monitoring for prevention of these complications. Results. Patient malpositioning during surgery is the main determining factor for the development of postoperative brachial plexus injury. Recovery occurs in the majority of cases but may require weeks to months of therapy after initial presentation. Conclusion. Brachial plexus injuries are an increasingly recognized complication following spinal surgery. Proper attention to patient positioning with the use of intraoperative electrophysiological monitoring techniques could minimize injury. (DOI: 10.3171/2010.4.SPINE09682)