Spinal accessory nerve transfer for shoulder abduction has no benefit over supraclavicular exploration and nerve grafting in brachial plexus birth injury: a systematic review
2024

Shoulder Surgery for Brachial Plexus Injury: Comparing Two Techniques

Sample size: 110 publication Evidence: moderate

Author Information

Author(s): Mendiratta Dhruv, Singh Rohan, Abdelmalek George, Pant Krittika, Chu Alice, McGrath Aleksandra

Primary Institution: Rutgers New Jersey Medical School

Hypothesis

Does spinal accessory nerve transfer produce better outcomes for shoulder abduction in brachial plexus birth injury compared to supraclavicular exploration and nerve grafting?

Conclusion

There is no difference in shoulder abduction outcomes between spinal accessory nerve transfer and nerve grafting for brachial plexus birth injury.

Supporting Evidence

  • The mean shoulder abduction Mallet score was 3.50 in the nerve grafting group and 3.58 in the nerve transfer group.
  • No significant relationship was found between age at surgery and post-operative Mallet scores.
  • Previous studies have shown varying outcomes for nerve transfer and grafting, but this review found no significant differences.

Takeaway

The study looked at two types of surgeries for babies with arm injuries at birth and found that one surgery didn't work better than the other.

Methodology

A systematic review was conducted using PRISMA guidelines, analyzing 10 studies with patient outcome measures based on Mallet scores.

Potential Biases

The studies had low to moderate risk of bias, with issues related to participant selection and missing data.

Limitations

Variability in outcome measures and follow-up periods across studies limited the ability to standardize results.

Participant Demographics

The mean age of patients was approximately 10 months, with 51 in the nerve grafting group and 59 in the nerve transfer group.

Statistical Information

P-Value

0.9012

Statistical Significance

p=0.9012

Digital Object Identifier (DOI)

10.3389/fped.2024.1426105

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