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Mark G. Burnett and Eric L. Zager

Clinicians caring for patients with brachial plexus and other nerve injuries must possess a clear understanding of the peripheral nervous system's response to trauma. In this article, the authors briefly review peripheral nerve injury (PNI) types, discuss the common injury classification schemes, and describe the dynamic processes of degeneration and reinnervation that characterize the PNI response.

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Shih-Shan Lang, Eric L. Zager, Thomas M. Coyne, Raj Nangunoori, J. Bruce Kneeland and Katherine L. Nathanson

's most recent surgical procedure in 2011 involved the removal of tumors from the left infraclavicular brachial plexus, the left breast, and the right medial thigh. All of the lesions were firm, well-encapsulated masses that arose from the nerve with one small fascicle entering and exiting at the poles of the tumor. Gross-total resection was performed in each case, with the assistance of neural monitoring. Genetic Testing Clinical genetic testing for mutations in NF1 was done at the University of Alabama (L. Messian laboratory). Initial genetic testing of the

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of those structures can be safe if appropriate technique is adopted. Full investigation of the anatomical position of the vessels might be required before surgery is performed. Neurosurg Focus Neurosurgical Focus FOC 1092-0684 American Association of Neurological Surgeons 2014.3.FOC-DSPNABSTRACTS Abstract Mayfield Clinical Science 233. Utility of Delayed Surgical Repair of Neonatal Brachial Plexus Palsy Zarina S Ali , MD , Dara Bakar , Yun Li , Alex Judd , Hiren C. Patel , MBBS, PhD

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Zarina S. Ali, Dara Bakar, Yun R. Li, Alex Judd, Hiren Patel, Eric L. Zager, Gregory G. Heuer and Sherman C. Stein

N eonatal brachial plexus palsy (NBPP) has an incidence of 1.5 cases per 1000 live births in the United States. 65 The most common form of NBPP involves the upper trunk roots (C-5, C-6) (Erb's palsy), occasionally occurring in combination with an injury to the C-7 root. Erb's palsy clinically results in loss of function of the supraspinatus, infraspinatus, deltoid, biceps brachii, brachialis, coracobrachialis, and supinator muscles, resulting in loss of shoulder abduction, external rotation, elbow flexion, and forearm supination. With the loss of the C-7

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Zarina S. Ali, Eric L. Zager, Gregory G. Heuer and Sherman C. Stein

T o T he E ditor : We thank you for publishing our paper, “Utility of delayed surgical repair of neonatal brachial plexus palsy. Clinical article.” ( J Neurosurg Pediatr 13: 462–470, 2014). After our paper had been published, a Letter to the Editor by Dr. Willem Pondaag and Dr. Martijn J. A. Malessy made us aware of some errors. The errors center around papers we cited in Table 3 . We are taking this opportunity to make corrections. The original Reference 18 in our manuscript (Chuang DC: Nerve transfers in adult brachial plexus injuries: my methods

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Willem Pondaag and Martijn J. A. Malessy

T o T he E ditor : We read with interest the article by Ali et al. 1 (Ali ZS, Bakar D, Li YR, et al: Utility of delayed surgical repair of neonatal brachial plexus palsy. Clinical article. J Neurosurg Pediatr 13: 462–470, April 2014) that describes a utility model on the timing of surgery in neonatal brachial plexus palsy (NBPP). The authors formulated a decision analytical model to compare 4 treatment strategies (no repair or repair at 3, 6, or 12 months of life) for infants with persistent NBPPs. The model derives data from published studies and

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Zarina S. Ali, Gregory G. Heuer, Ryan W. F. Faught, Shriya H. Kaneriya, Umar A. Sheikh, Idrees S. Syed, Sherman C. Stein and Eric L. Zager

U pper trunk brachial plexus injuries involving the C5–6 roots result in significant disability due to a loss of shoulder abduction, external rotation, elbow flexion, and forearm supination. Involvement of the C-7 spinal root may lead to deficits involving additional movements, including finger, wrist, and elbow extension. The severity of these injuries varies from a neurapraxic injury, which typically resolves spontaneously, to a complete avulsion injury, which has no potential for spontaneous recovery. In adults, the restoration of elbow flexion is the

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Jennifer Hong, Jared M. Pisapia, Zarina S. Ali, Austin J. Heuer, Erin Alexander, Gregory G. Heuer and Eric L. Zager

T horacic outlet syndrome (TOS) is a neurovascular compression syndrome caused by constriction of the brachial plexus or subclavian artery and vein as they exit the thoracic outlet. This syndrome can have a variable presentation, and symptoms are typically divided into vascular or neurogenic, although an individual may have a mixture of both. Neurogenic TOS (nTOS) has a wide constellation of symptoms including pain, paresthesias, and motor deficits in the neck and/or extremity. 26 The diagnosis of TOS is controversial, because the definition describes the