The brachial plexus is the net of nerves that sends signals from the spine to the shoulder, arm or hand. Its injury mostly occurs when the nerves get stretched, compressed or in severe cases ripped apart or torn away from the spinal cord. Surgical procedures like nerve grafting, nerve transfer or muscle transfers can help in restoring the function.

Brachial plexus injuries, a stereotactic procedure in Singapore

Singapore is hospitable for all it international patients each year, visiting the country for a range of medical care including from screening to high-end surgical procedures. The healthcare centers in Singapore provides an affordable, accessible, quality healthcare. Most of the surgeons have done their fellowship from some of the top center’s globally and have gained recognition in their respective fields. Few of them are actively involved in the research, development, and education on their subject.

Cost comparison

 

The cost of brachial plexus treatment in Singapore, the fineness of therapy, skilled doctors and aftercare provided are at par with few of the most popular medical tourism destinations like UAE, India, Turkey, Thailand, and Hungary. Brachial plexus treatment cost in Singapore including the hospitalization cost, implant cost, and doctors’ fees is almost half when compared with the treatment cost offered in US or UK.

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Brachial plexus injury is a medical emergency caused due to an injury to the brachial plexus group of nerves that sends signals from your spine to your shoulder, arm, and hand. These nerves control and administer feelings in the muscles of the shoulder, elbow, wrist, hand, and arm. This damage is also known as brachial plexopathy. Brachial plexus injury appears when these nerves are compressed, stretched, or in the most serious case, ripped apart from the spinal cord. Some brachial plexus injuries known as stingers or burners are inconsequential and will completely recover in a few weeks. However, other brachial plexus injuries are severe enough and may cause some permanent impairment in the arm. In severe conditions, it can paralyze your arm, with a failure of function and sensation.


Brachial Plexus Injury Causes

Brachial plexus injury results when the brachial nerves are damaged by excessive stretching, pressure, or cutting. Stretching can occur when your shoulder is forced down while your neck stretches up and away from the injured shoulder such as during a motorcycle or a car accident. In case of a serious injury, the brachial nerve may rip off the spinal cord in the neck. This type of brachial plexus injury is classified as traumatic brachial plexus injuries. It may occur because of different reasons, including:

  • Contact sports: Contact sports players may experience burners or stingers, which can occur when the nerves in the brachial plexus get stretched above their limits during collisions with other players.
  • Trauma: Several types of trauma, including motorcycle and car accidents or bullet wounds, can result in a brachial plexus injury.
  • Inflammation: Inflammation may also cause damage to the brachial plexus. An uncommon condition known as Parsonage-Turner syndrome or brachial plexitis causes brachial plexus inflammation without any trauma.
  • Tumors: Noncancerous (benign) or cancerous tumors may damage the brachial plexus.
  • Childbirth: Injury during complication of childbirth.

Brachial plexopathy may also result from exposure to radiation at the time of stereotactic radiosurgery or specific procedures such as stereotactic breast biopsy.


Brachial Plexus Injury Symptoms

Symptoms of the brachial plexus injury depend on the seriousness of the injury. A minor injury can often occur during any contact sport and minor trauma when the brachial plexus nerves get stretched or compressed. Minor brachial plexus injury symptoms include the following:

  • Burning sensation and shocks shooting down your arm
  • Weakness and numbness in your arm

More serious brachial plexus injury symptoms result when nerves are torn or ruptured. Such injuries may produce the following symptoms:

  • Weakness or inability to use certain muscles of hand, arm or shoulder
  • Complete lack of movement and feelings (paralysis) in your arm, including your shoulder and hand
  • Severe pain

In case of childbirth brachial plexus injury, symptoms can be seen right after the birth of the child. These may include:

  • No movement in the upper or lower arm or hand of the baby
  • Arm flexed (bent) at the elbow and held against the body
  • Absence of Moro reflex on the affected side
  • Decreased grip on the affected side

Some common types of surgical brachial plexus injury treatment include the following:

  • Nerve grafting: Surgically removing and replacing the damaged part of the brachial plexus with sections of nerves harvested from other parts of the body is called nerve grafting. 
  • Nerve transfer: This type of surgery is opted when the nerve root has been torn from the spinal cord. A surgeon often takes a less important nerve that is still attached to the spinal cord and connects it to the nerve that is ripped off from the spinal cord. Occasionally, a combination of nerve graft and nerve transfer is performed.
  • Muscle transfer: During this surgery, your surgeon removes a less important muscle or ligament from another part of your body and transfers it to your arm, and restores the nerves and blood vessels supplying that muscle.

It is very hard to assess an exact recovery time after brachial plexus injury treatment due to the broad spectrum. How likely a spontaneous recovery depends on the type and severity of the injury.

In the case of surgery, nerve tissue grows very slowly, about an inch a month, so it can take a few years to assess the success of brachial plexus injury surgery. However, during the recovery period, patients are encouraged to keep their joints flexible by following an exercise schedule. The success rate of surgery is quite good but recovery time and success rate must be assessed on an individual basis.

Frequently Asked Questions

Singapore is generally known for its well-managed health care infrastructure and has an efficient and widespread system of healthcare. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000. Bloomberg ranked Singapore's healthcare system the most efficient in the world in 2014. Three main healthcare groups exist in Singapore:
  • National Healthcare Group
  • National University Health System
  • SingHealth
The 10 public hospitals in Singapore comprise 8 general hospitals (AH, SGH, NUH, CGH, TTSH, KTPH, NTFGH & SKH), and 2 specialized hospitals (KKH & IMH). In addition, there are 9 national specialty centres for cancer (NCCS & NCIS), cardiac (NHCS & NUHCS), eye (SNEC), skin (NSC), neuroscience (NNI) and dental care (NDCS & NUCOHS). The private healthcare infrastructure in Singapore is also well established. The payment methods include private payment gateways or private insurance companies. You can expect better technology to be used in private hospitals in Singapore. Various procedures like stem cell therapy and cancer research are conducted in Singapore.
The Joint Commission International (JCI) is a global leader in health care accreditation. JCI accreditation is considered a gold standard in worldwide health care. It provides the most skilled and experienced healthcare professionals in the medical industry, as evaluators of the rigorous international standards in healthcare quality and patient safety. Here are some of the JCI certified hospitals in Singapore :
  • Mount Elizabeth Hospital
  • Singapore National Eye Centre
  • National Dental Centre
  • Raffles Hospital
  • National University Hospital
  • Gleneagles Hospital
  • Singapore General Hospital
  • National Heart Centre Singapore
  • Changi General Hospital
  • National Cancer Centre
  • National Skin Centre
  • Johns Hopkins Singapore International Medical Centre
  • Tan Tock Seng Hospital
Since Singapore is known all over the world for some of the best medical treatments all across the globe, you can surely expect the best quality of doctors and surgeons here. This country has a very high quality of life and hence the health of people is of high priority.
People who wish to go to Singapore as a tourist for social purposes or seeking medical treatment, and require a longer period of stay beyond the Visit Pass granted on entry into Singapore, may submit an application for extension of stay (not more than 89 days from date of entry) online using the e-Service of ICA. All extension applications must be submitted online using the e-service at least seven days prior to the expiry of the visit pass to avoid overstaying. Extension of visit will not be accepted over the counter. Every visit pass issued to any person as a tourist or for the purpose of a social visit or medical treatment shall be subjected to the condition that the holder shall not engage in any form of employment (paid or unpaid) or in any business, profession or occupation in Singapore during the validity of that pass unless he is a holder of a valid work pass issued under the Employment of Foreign Manpower Act. Do visit the ICA website for further information.
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