Chronic invasive electrical stimulation at treatment of obstetric brachial plexus injury
Keywords:injury of obstetric brachial plexus, surgical treatment, prolonged electrical stimulation
Introduction. Annually up 0.35 to 5 to 1000 of newborns suffer severe injury of brachial plexus at delivery. The majority of newborns require surgery to restore proper functioning of brachial plexus.
Materials and methods. 22 patients with implications of injury of brachial plexus at delivery underwent surgery during which the electrical stimulation system has been implanted. We performed neurolysis and decompression of neural structures of brachial plexus in all of patients, followed by implantation of platinum-based electrodes upon abovementioned neural structures of brachial plexus. Every single patient who underwent surgery applied individual system for prolonged electrical stimulation “Нейси-3M”. This individual system allows one to perform electrical stimulation several times a day during a long period of time, this approach significantly increases the efficacy of treatment.
Results. In 19 (86%) patients range of motion improved significantly, strength of muscles of shoulder and upper extremity, sensation also improved significantly.
Conclusion. Prolonged electrical stimulation of structures of brachial plexus is safe and effective method of influence on functional status of injured at delivery neuromuscular apparatus of upper extremity.
1. Baindurashvili A G, Naumochkina NA, Ovsyankin NA. Rodovyye vyalyye paralichi verkhnikh konechnostey. Travmatologiya i ortopediya Rossii. 2011;2(60):171-178. Russian.
2. Yeltsin AG. Operativnoye lecheniye neyrogennykh deformatsiy, vyzvannykh povrezhdeniyami plechevogo spleteniya u detey. [dissertation]. Moscow (Russia); 2003. Russian.
3. Komarevtsev VD. Diagnostika i lecheniye rodovogo paralicha verkhney konechnosti u detey. [dissertation]. Yaroslavl (Russia); 2000. Russian.
4. Antoniadis G, Richter HP, Kretschmer T. Role of intraoperative neurophysiology in primary surgery for obstetrical brachial plexus palsy (OBPP). Childs Nerv Syst. 2006;22(7):710-714. [CrossRef]
5. Mollberg M, Lagerkvist A, Johansson U, Bager B, Johansson A, Hagberg H. Comparison in Obstetric Management on Infants With Transient and Persistent Obstetric Brachial Plexus Palsy. Journal of Child Neurology. 2008;23(12):1424-1432. [CrossRef]
6. Gilbert W. Associated factors in 1611 cases of brachial plexus injury. Obstetrics & Gynecology. 1999;93(4):536-540. [CrossRef]
7. Maillet M, Romana C. Complete obstetric brachial plexus palsy: surgical improvement to recover a functional hand. J Child Orthop. 2009;3(2):101-108. [CrossRef]
8. Sinanovice O, Pirice N, Salihovice D, Zonice L, Zonice R. [Obstetric lesions of brachial plexus]. Med. Arh. 2006;60(4):255—258. Bosnian. [PubMed]
9. Qin B, Gu L, Liu X, Zhang Z, Xiang J, Wang H, Fu G. [Value of MRI in diagnosis of obstetrical brachial plexus palsy pre-ganglionic injury]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2008;22(12):1455-1457. Chinese. [PubMed]
10. Strombeck C. Follow–up studies of the obstetrical brachial plexus injury. C. Strombeck. — Stockholm: Karolinska Insitute; 2006.
11. Terzis J, Kokkalis Z. Pediatric Brachial Plexus Reconstruction. Plastic and Reconstructive Surgery. 2009;124:370-385. [CrossRef]
12. Badr Y, O’Leary S, Kline D. Management of one hundred seventy-one operative and nonoperative obstetrical birth palsies at the Louisiana State University Health Sciences Center. Neurosurgery. 2009;65:(2):67-73. [CrossRef]
13. Fitoussi F, Maurel N, Diop A et al. Upper extremity kinematics analysis in obstetrical brachial plexus palsy. Orthopaedics & Traumatology: Surgery & Research. 2009;95(5):336-342. [CrossRef]
14. Naumochkina NA, Ovsyankin NA. Konservativnoye lecheniye patsiyentov s akusherskim paralichom verkhney konechnosti. Travmatologiya i ortopediya Rossii. 2011;4(62):83—88. Russian.
15. Koreneva MM. Effektivnost etapnogo vosstanovitelnogo lecheniya detey s posledstviyami rodovykh perifericheskikh parezov verkhney konechnosti. [dissertation]. Pyatigorsk (Russia); 2005. Russian.
16. Mikhaylova SA. Dlitelnyye narusheniya v pozdnem periode akusherskikh parezov i ikh korrektsiya funktsionalnym bioupravleniyem. [dissertation]. Moscow (Russia); 2008. Russian.
19. Vekris M, Lykissas M, Beris A, Manoudis G, Vekris A, Soucacos P. Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers. Microsurgery. 2008;28(4):252-261. [CrossRef] [PubMed]
21. Dolnitskiy OV. Lecheniye rodovogo paralicha verkhnikh konechnostey [Treatment generic paralysis of the upper extremities]. Kiev: Zdorovya; 1985. Russian.
22. Hoeksma A, Ter Steeg A, Nelissen R, Van Ouwerkerk W, Lankhorst G, De Jong B. Neurological recovery in obstetric brachial plexus injuries: an historical cohort study. Developmental Medicine & Child Neurology. 2004;46(2):76-83. [CrossRef]
23. Tretyak I.B Vykorystannya tryvaloyi elektrostymulyatsiyi pry ushkodzhenni peryferychnykh nerviv ta spleten’. Ukrainian Neurosurgical Journal. 2007;2:58-61. Ukrainian.
24. Alrashdan MS, Park JC, Sung MA, Yoo SB, Jahng JW, Lee TH, Kim SJ, Lee JH. Thirty minutes of low intensity electrical stimulation promotes nerve regeneration after sciatic nerve crush injury in a rat model. Acta Neurol Belg. 2010;110(2):168-79.
26. Shapiro S, Borgens R, Pascuzzi R et al. Oscillating field stimulation for complete spinal cord injury in humans: a Phase 1 trial. Journal of Neurosurgery: Spine. 2005;2(1):3-10. [CrossRef] [PubMed]
29. Krames ES editor, Peckham PH, Rezai AR, Aboelsaad F. What is neuromodulation? Neuromodulation. London: Elsevier; 2009.
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