Comparison of neuropathic pain characteristics associated with total brachial plexus injury before and after surgical repair: A retrospective study.
OBJECTIVES
The goal of this study was to compare clinical characteristics of neuropathic pain associated with total brachial plexus injury before and after surgeries and to correlate possible contributing factors concerning to the pain prognosis.


PATIENTS AND METHODS
Thirty patients with both total brachial plexus injury and neuropathic pain were included. Neuropathic pain was evaluated in terms of pain intensities, symptoms and regions. Pain intensities were evaluated by a visual analogue scale. The Neuropathic Pain Symptoms Inventory questionnaire and body maps were used to compare the pain symptoms and regions. Demographic data, injury and repair information were evaluated to analyze the possible factors influencing the prognosis.


RESULTS
The average pain score of all participants was 7.13 ± 2.46 preoperatively and 5.40 ± 2.08 postoperatively. All patients were divided into Pain Relief Group and Pain Aggravation Group. Older age (p = 0.042), machine traction injury (p = 0.019)and nerve transplantation(p = 0.015) seemed to be related with pain aggravation. Paroxysmal pain was aggravated after surgical repairs (p = 0.041), while paresthesia/dysesthesia improved after surgery (p = 0.003). The permanent component of the pain (spontaneous pain) did not show any significant change (p = 0.584). Pain in C5 (p < 0.001) and C6 (p = 0.031) dermatomes got relieved after surgery.


CONCLUSION
This study revealed the neuropathic pain of most patients with total brachial plexus injury was alleviated after neurosurgery, and the pain prognosis of different symptoms and regions varied after the nerve repair.
['Guo|Jinding|J|', 'Gao|Kaiming|K|', 'Zhou|Yingjie|Y|', 'Zhao|Xin|X|', 'Lao|Jie|J|']
D000055:Accessory Nerve D000328:Adult D001917:Brachial Plexus D020516:Brachial Plexus Neuropathies D018450:Disease Progression D005260:Female D006801:Humans D007367:Intercostal Nerves D008297:Male D008875:Middle Aged D016067:Nerve Transfer D009437:Neuralgia D019635:Neurosurgical Procedures D010147:Pain Measurement D010292:Paresthesia D059348:Peripheral Nerve Injuries D010791:Phrenic Nerve D011379:Prognosis D012189:Retrospective Studies D013127:Spinal Nerves D013497:Sural Nerve D016896:Treatment Outcome D055815:Young Adult
Neuropathic pain Brachial plexus Neurosurgery Prognostic factors Surgical outcomes