Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus
CPT4 code
Name of the Procedure:
Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus
Summary
In a layman’s terms, this surgical procedure involves the repair or decompression of nerves in the brachial plexus, a network of nerves that sends signals from your spine to your shoulder, arm, and hand. It is typically done through an open surgery, meaning a surgical incision is made to access the nerves.
Purpose
Medical Condition or Problem Addressed:
The procedure is primarily performed to address nerve damage, compression, or entrapment that causes pain, weakness, or loss of function in the arm.
Goals or Expected Outcomes:
The goals are to relieve pain, restore nerve function, and improve mobility and strength in the affected arm.
Indications
Symptoms or Conditions Warranting the Procedure:
- Chronic or severe arm pain
- Weakness or paralysis in the arm or hand
- Numbness or tingling in the arm
- Nerve compression syndromes like thoracic outlet syndrome
Patient Criteria:
- Individuals who have not responded well to conservative treatments
- Patients with significant functional impairment
Preparation
Pre-procedure Instructions:
- Fast (no eating or drinking) for at least 8 hours prior to surgery
- Adjust or stop certain medications as advised by your doctor
- Undergo preoperative blood tests and imaging studies like MRI or CT scans
Procedure Description
Step-by-Step Explanation:
- The patient is placed under general anesthesia.
- An incision is made over the site of the brachial plexus.
- The surgeon carefully exposes the affected nerve.
- Nerve decompression or repair is performed using microsurgical techniques.
- The incision is then closed with sutures.
Tools, Equipment, and Technology:
- Surgical microscope
- Microsurgical instruments
- Sutures and surgical gauze
Anesthesia or Sedation:
General anesthesia is typically used to ensure the patient is unconscious and does not feel pain during the procedure.
Duration
The procedure generally takes between 2 to 4 hours, depending on the complexity of the case.
Setting
This surgery is performed in a hospital operating room.
Personnel
- Surgeon, typically a neurosurgeon or orthopedic surgeon specialized in nerve surgeries
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
Common and Rare Risks:
- Infection
- Bleeding or hematoma
- Nerve damage
- Scarring
Possible Complications:
- Persistent pain or numbness
- Muscle weakness
- Need for additional surgeries
Benefits
The expected benefits include relief from pain, improved nerve function, and restored strength and mobility in the arm. Benefits might be realized within weeks to months after the procedure, depending on individual recovery.
Recovery
Post-procedure Care and Instructions:
- Keep the surgical area clean and dry
- Take prescribed pain medications as needed
- Engage in physical rehabilitation as instructed
Expected Recovery Time:
Full recovery may take several months, with some restrictions on lifting and strenuous activities during the initial weeks.
Alternatives
Other Treatment Options:
- Physical therapy
- Medications (pain relievers, anti-inflammatory drugs)
- Minimally invasive procedures like nerve blocks
Pros and Cons of Alternatives:
- Physical therapy and medications might not provide sufficient relief for severe cases.
- Minimally invasive procedures might offer temporary relief but not address the underlying problem as effectively as open surgery.
Patient Experience
During the Procedure:
The patient will be under general anesthesia and will not experience pain during the surgery.
After the Procedure:
The patient might experience some pain, swelling, or bruising at the surgical site, which can be managed with medications. Rehabilitation exercises will be necessary to restore full function.