Nerve Graft Surgery

Forum for parents of injured who are seeking information from other parents or people living with the injury. All welcome
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mamaofsix
Posts: 214
Joined: Sun May 11, 2008 5:20 pm
Injury Description, Date, extent, surgical intervention etc: Second son, Cameron, left obstetric brachial plexus injury in 2005.
Primary never graft surgery at 3 months old at St. Louis Children's Hospital
and several rounds of Botox injections.

Nerve Graft Surgery

Post by mamaofsix »

Our specialist scheduled our son for nerve graft surgery on June 11. He will be a little over 3 months old. He believes the c5,c6,c7 are damaged. Please keep us in your prayers.
AyoubsMom
Posts: 16
Joined: Mon Apr 28, 2008 1:31 pm

Re: Nerve Graft Surgery

Post by AyoubsMom »

How much does this kinda surgery cost...this is what my son needs too.
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F-Litz
Posts: 970
Joined: Fri May 26, 2006 6:53 pm
Injury Description, Date, extent, surgical intervention etc: LOBPI, LTBPI at age 6.5, Sensory Issues, CP, Diaphragm Weakness, Aspberger's
Location: Ambler, PA

Re: Nerve Graft Surgery

Post by F-Litz »

Going out on a limb here.... if it's C5-6-&7 that he feels is damaged, can't he give them a bit more time? Everything I've read always pointed to 4 to 6 months as the time frame for biceps innervation. Does your son have any movement at all?
AyoubsMom
Posts: 16
Joined: Mon Apr 28, 2008 1:31 pm

Re: Nerve Graft Surgery

Post by AyoubsMom »

He has movement in his arm, i mean he raises his arm up little bit off the ground but not bending elbow. He has wrist, fingers and shoulder movements.

I still do infant range motion and noticed that his lower arm is becoming more stronger because he is trying to resist when i do up and down movement when I bend his elbow.

He also seem to get so upset when trying to raise his BPI arm.

take care and thanks
mamaofsix
Posts: 214
Joined: Sun May 11, 2008 5:20 pm
Injury Description, Date, extent, surgical intervention etc: Second son, Cameron, left obstetric brachial plexus injury in 2005.
Primary never graft surgery at 3 months old at St. Louis Children's Hospital
and several rounds of Botox injections.

Re: Nerve Graft Surgery

Post by mamaofsix »

Our specialist said we can wait, but he wouldn't recommend it.
mamaofsix
Posts: 214
Joined: Sun May 11, 2008 5:20 pm
Injury Description, Date, extent, surgical intervention etc: Second son, Cameron, left obstetric brachial plexus injury in 2005.
Primary never graft surgery at 3 months old at St. Louis Children's Hospital
and several rounds of Botox injections.

Re: Nerve Graft Surgery

Post by mamaofsix »

I didn't fully answer the question. He does have movement. He doesn't have any active shoulder external rotaion, forearm supination, wrist extension or elbow movement.
User avatar
F-Litz
Posts: 970
Joined: Fri May 26, 2006 6:53 pm
Injury Description, Date, extent, surgical intervention etc: LOBPI, LTBPI at age 6.5, Sensory Issues, CP, Diaphragm Weakness, Aspberger's
Location: Ambler, PA

Re: Nerve Graft Surgery

Post by F-Litz »

Have you thought about getting more opinions?
katep
Posts: 1240
Joined: Mon Mar 29, 2004 3:20 pm

Re: Nerve Graft Surgery

Post by katep »

This sounds incredibly aggressive by your description. External rotation and supination VERY rarely come in by 3 months old and certainly are NOT indications for primary surgery. If his hand is functioning well, I would definitely give him another month or two before doing primary surgery. Our son didn't get hand-to-mouth until just shy of 5 months old. Both specialists he saw said that he had enough function in wrist/elbow/hand that his recovery would be better than if he had primary surgery.

Is your surgeon talking about doing a very targeted nerve graft just for the missing movements? In that case, perhaps this kind of aggression is warranted. But if we was suggesting a full plexus reconstruction at 3 months old on a child who has as much function as you describe, I would definitely get a second opinion. I know time is close, but you can do opinions via video and email with many specialists.

Kate
katep
Posts: 1240
Joined: Mon Mar 29, 2004 3:20 pm

Re: Nerve Graft Surgery

Post by katep »

I checked that website you gave, and it sounds like they use the Toronto score at 3 months of age to evaluate for full plexus reconstruction which is pretty conservative and then at "Three-five months: Isolated selective nerve transfers, if needed for improvement".

So it doesn't sound like what he is suggesting is full-blown brachial plexus reconstruction but targeted nerve work to get specific movements like external rotation/etc that seem to be lacking. That sounds a whole lot more reasonable!

Kate
mamaofsix
Posts: 214
Joined: Sun May 11, 2008 5:20 pm
Injury Description, Date, extent, surgical intervention etc: Second son, Cameron, left obstetric brachial plexus injury in 2005.
Primary never graft surgery at 3 months old at St. Louis Children's Hospital
and several rounds of Botox injections.

Re: Nerve Graft Surgery

Post by mamaofsix »

Kate,

Thank you for your responses. I have sent a video out to a couple of specialists and they both said they can't give a recommendation without seeing him in person. This is very overwhelming. Trying to decide if this is best for him right now or to wait. Like all of us, I want what is best for my son. I trust our specialist, but like we all know, this is so complex. Our specialist will be doing isolated nerve transfers to get specific movements back.
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