Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review
BackgroundWe analyzed trends in age at surgery and surgical approach over time and geography.MethodsWe performed a systematic review according to PRISMA-IPD guidelines to include individual patient data. Collected data included age at surgery, location of surgery, and surgical approach. The surgical...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1359719/full |
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| author | Michael F. Levidy Amanda Azer Jasmine Shafei Nivetha Srinivasan Jasmine Mahajan Shivani Gupta George Abdelmalek Krittika Pant Kunj Jain Yash Shah Zheshi Zheng Johnny Chuieng-Yi Lu Tommy Nai-Jen Chang Alice Chu Aleksandra McGrath Aleksandra McGrath |
| author_facet | Michael F. Levidy Amanda Azer Jasmine Shafei Nivetha Srinivasan Jasmine Mahajan Shivani Gupta George Abdelmalek Krittika Pant Kunj Jain Yash Shah Zheshi Zheng Johnny Chuieng-Yi Lu Tommy Nai-Jen Chang Alice Chu Aleksandra McGrath Aleksandra McGrath |
| author_sort | Michael F. Levidy |
| collection | DOAJ |
| description | BackgroundWe analyzed trends in age at surgery and surgical approach over time and geography.MethodsWe performed a systematic review according to PRISMA-IPD guidelines to include individual patient data. Collected data included age at surgery, location of surgery, and surgical approach. The surgical approach was independently categorized as the exploration of the brachial plexus (EBP) or nerve transfer without root exploration (NTwoRE). EBP was defined as exploring the brachial plexus in the supraclavicular fossa and applying a choice of coaptation procedures. NTwoRE included those sourcing donor nerves from, or entirely occurring outside of the plexus without exploring the root of the brachial plexus.ResultsRegression analysis of age at surgery 1985–2020 showed that age at BPBI surgery is rising (p < 0.05). Surgery was performed at a younger age in patients from Europe (7.06 ± 7.77 months) and Asia (7.58 ± 5.33 months) than those from North America (10.44 ± 5.01 months) and South America (14.71 ± 4.53 months) (p < 0.05). NTwoRE was more common in North America (37%) and least common in Europe (12%). Age at EBP was 7.2 ± 5.77 months, and age at NTwoRE was 15.85 ± 13.18 months (p < 0.05). The incidence of NTwoRE is increasing time.ConclusionsAge at NBPP surgery is increasing over time. Regional differences exist in age at NBPP surgery. Approaches to NBPP surgery that avoid exploration of BP roots are becoming more popular. Age at EBP is lower than age at NTwoRE. |
| format | Article |
| id | doaj-art-dfb887f68db84a8fb4c47bf96b9ae6d2 |
| institution | Kabale University |
| issn | 2296-875X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj-art-dfb887f68db84a8fb4c47bf96b9ae6d22025-01-06T04:12:15ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011110.3389/fsurg.2024.13597191359719Global trends in surgical approach to neonatal brachial plexus palsy: a systematic reviewMichael F. Levidy0Amanda Azer1Jasmine Shafei2Nivetha Srinivasan3Jasmine Mahajan4Shivani Gupta5George Abdelmalek6Krittika Pant7Kunj Jain8Yash Shah9Zheshi Zheng10Johnny Chuieng-Yi Lu11Tommy Nai-Jen Chang12Alice Chu13Aleksandra McGrath14Aleksandra McGrath15Department of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang Gung Medical College and Chang Gung University, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Surgical and Perioperative Sciences, Faculty of Medicine, Umeå University, Umeå, SwedenDepartment of Orthopedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, United StatesDepartment of Clinical Sciences, Umeå University, Umeå, SwedenDepartment of Surgical and Perioperative Sciences, Faculty of Medicine, Umeå University, Umeå, SwedenBackgroundWe analyzed trends in age at surgery and surgical approach over time and geography.MethodsWe performed a systematic review according to PRISMA-IPD guidelines to include individual patient data. Collected data included age at surgery, location of surgery, and surgical approach. The surgical approach was independently categorized as the exploration of the brachial plexus (EBP) or nerve transfer without root exploration (NTwoRE). EBP was defined as exploring the brachial plexus in the supraclavicular fossa and applying a choice of coaptation procedures. NTwoRE included those sourcing donor nerves from, or entirely occurring outside of the plexus without exploring the root of the brachial plexus.ResultsRegression analysis of age at surgery 1985–2020 showed that age at BPBI surgery is rising (p < 0.05). Surgery was performed at a younger age in patients from Europe (7.06 ± 7.77 months) and Asia (7.58 ± 5.33 months) than those from North America (10.44 ± 5.01 months) and South America (14.71 ± 4.53 months) (p < 0.05). NTwoRE was more common in North America (37%) and least common in Europe (12%). Age at EBP was 7.2 ± 5.77 months, and age at NTwoRE was 15.85 ± 13.18 months (p < 0.05). The incidence of NTwoRE is increasing time.ConclusionsAge at NBPP surgery is increasing over time. Regional differences exist in age at NBPP surgery. Approaches to NBPP surgery that avoid exploration of BP roots are becoming more popular. Age at EBP is lower than age at NTwoRE.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1359719/fullbrachial plexusneonatal brachial palsytrendsnerve transfernerve exploration |
| spellingShingle | Michael F. Levidy Amanda Azer Jasmine Shafei Nivetha Srinivasan Jasmine Mahajan Shivani Gupta George Abdelmalek Krittika Pant Kunj Jain Yash Shah Zheshi Zheng Johnny Chuieng-Yi Lu Tommy Nai-Jen Chang Alice Chu Aleksandra McGrath Aleksandra McGrath Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review Frontiers in Surgery brachial plexus neonatal brachial palsy trends nerve transfer nerve exploration |
| title | Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review |
| title_full | Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review |
| title_fullStr | Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review |
| title_full_unstemmed | Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review |
| title_short | Global trends in surgical approach to neonatal brachial plexus palsy: a systematic review |
| title_sort | global trends in surgical approach to neonatal brachial plexus palsy a systematic review |
| topic | brachial plexus neonatal brachial palsy trends nerve transfer nerve exploration |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2024.1359719/full |
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