United Brachial Plexus Network, Inc.

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.

How much does this kinda surgery cost...this is what my son needs too.

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?

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

Our specialist said we can wait, but he wouldn't recommend it.

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.

Have you thought about getting more opinions?

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

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

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.