Treatment of Burner's Syndrome with Neurotmesis of the Brachial Plexus or Cervical Nerve Roots
Clinical scenario
This protocol addresses Burner's syndrome occurring in the setting of neurotmesis of the brachial plexus or cervical nerve roots — the most severe grade of nerve injury, characterised by complete, irreversible neural damage that cannot resolve through the body's innate healing process and typically requires surgical intervention to achieve functional recovery.
Management approach
Initial management centres on pain relief, structural protection, and a supervised rehabilitation programme. Certain interventional techniques may be considered alongside conservative care, though their use requires careful patient selection given the nature of the injury.
Full sequenced regimen, selection criteria, and clinical decision points are available via the link below.
References
DOI: 10.3390/app15073510
- This grade can be further categorized into Grade IIIA, or neurotmesis, where complete, irreversible neural damage occurs.
- Grade III stingers are irrecoverable through the body's innate healing process and require surgical intervention to facilitate functional recovery.
- Pain is controlled with rest, analgesics, and a cervical collar.
- Cervical region epidural injections can also be used; however, utmost caution should be exercised because of the risks of traumatizing the cord directly during the procedure or indirectly due to the high pressure from administering medication in a narrowed and compromised canal.
- The current suggestion is to wait 3 to 6 months to allow reinnervation and settle concomitant injuries that make surgery unfeasible.
View source ↗