Nerve Repair and Nerve Grafting in Brachial Plexus Injuries

Brachial plexus injuries (BPI) can have devastating effects on upper extremity function, however, treatment in this injuries remains a difficult problem. Several kinds of surgical methods have been used to treat BPI, and nerve repair and nerve grafting have been traditionally used in postganglionic injury of brachial plexus. Because the several studies reported that nerve transfer to restore shoulder and elbow function has yielded superior results to historical reports for nerve grafting in partial BPI, the indication of nerve repair and nerve grafting has been decreased. Nonetheless, nerve repair and nerve grafting is still useful in focal damage in brachial plexus, such as laceration or gunshot wound and postganglionic neuroma in continuity without conduction of nerve action potential. In this paper, we described the basic concept, detailed indication and outcomes of nerve repair or nerve grafting in BPI.

Causes and Clinical Manifestations of Cauda Equina Syndrome

STUDY DESIGN: A literature review. OBJECTIVES: To describe the causes and clinical characteristics of cauda equina syndrome. SUMMARY OF LITERATURE REVIEW: The cauda equina syndrome, complex symptoms and signs expressed as variable clinical manifestation, has rare incidence but needs attention since it can bring about serious complications and sequales if neglected. MATERIALS AND METHODS: The Author reviewed articles reporting the causes and clinical manifestation of cauda equina syndrome. RESULTS: There are marked inconsistencies in the current evidence base surrounding the definition due to various clinical presentation of cauda equina syndrome. CONCLUSION: As there is no symptom or sign which has an absolute diagnostic value in establishing the diagnosis of cauda equina syndrome, any patient in whom a clinical suspicion of cauda equina syndrome arises must undergo urgent magnetic resonance imaging for diagnosis.