Sensory Nerve Transfer for Intractable Neuropathic Pain in a Case of C8-T1 Root Avulsion in Brachial Plexus Injury.

Abstract

Neuropathic pain in root avulsion brachial plexus injury (BPI) is severe and unrelenting. Routine analgesics and other described methods often provide inadequate pain relief. We report a patient with neuropathic pain following C₈T₁ root avulsion injury, which was successfully managed with end-to-side ulnar sensory branch transfer to the median nerve. Postoperatively, there was a marked reduction in pain score as determined by visual analogue score (VAS) and a marked improvement in the daily sleep interference scale (DSIS). This option may be considered in patients with severe neuropathic pain in lower root avulsion injury in BPI. Level of Evidence: Level V (Therapeutic).