Incidence of Neuropathic Pain in Operated Traumatic Brachial Plexus Injury in Adults: A Long-Term Follow-up

The study is titled Incidence of Neuropathic Pain in Operated Traumatic Brachial Plexus Injury in Adults A Long-Term Follow-up.

Traumatic brachial plexus injuries cause severe disability and neuropathic pain is a common complication. The prevalence and long-term characteristics of neuropathic pain after nerve reconstruction surgery are not well documented. This prospective observational study aims to evaluate its incidence, severity, and impact.

Earlier studies reported neuropathic pain in 50 to 76 percent of patients with brachial plexus injuries. Factors such as nerve avulsion, alcohol, smoking, and severity of injury are associated with higher risk. Neuropathic pain negatively affects quality of life and mood.

The aim of the present study is to evaluate the incidence and characteristics of neuropathic pain in adult patients who underwent nerve reconstruction for traumatic brachial plexus injury with at least two years of follow-up. The primary objective is to assess demographic and injury characteristics of patients with neuropathic pain. Secondary objectives are to measure pain severity using the DN4 scale, characterize pain using the Brief Pain Inventory Short Form and the Neuropathic Pain Symptom Inventory, and evaluate functional performance using the Australian modified Karnofsky Performance Scale.

The study design is prospective observational. The sample size is 48, calculated based on a prevalence of 69 percent with adjustment for dropout. Inclusion criteria are adults aged 15 to 65 years with surgically treated traumatic brachial plexus injury confirmed by history, examination, electromyography, and surgical exploration. Exclusion criteria include medical management only, comorbid diseases that may cause neuropathic pain, and primary surgery performed more than one year after injury.

Patients will undergo baseline and follow-up evaluations using DN4, BPI-SF, AKPS, NPSI, and visual analog scale for pain. Pain intensity, symptoms, and location will be assessed longitudinally. Surgical interventions include exploration and reconstruction with nerve grafts and transfers.

Statistical analysis will be done using SPSS version 23 with chi square for categorical variables and t test or ANOVA for grouped variables. A p value less than 0.05 will be considered significant.