{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T13:39:05Z","timestamp":1790429945337,"version":"4.1.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2006,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The purpose of this study was to investigate the usefulness of preoperative evaluation based on clinical testing and computed tomography (CT) myelography in differentiating root rupture (that is, graftable root) from root avulsion in total brachial plexus palsy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Thirty-two patients with total brachial plexus palsy were clinically tested for the presence of phrenic nerve palsy, supraclavicular Tinel sign, shoulder protraction, Bernard\u2013Horner syndrome, and hand pain. The patients underwent CT myelography and then underwent surgery. The combination of a positive Tinel sign and a positive shoulder protraction test accurately predicted the presence of a graftable root in 93.7% of the cases. A 96.8% rate of accuracy was attained if the results of the CT myelography were considered together with the clinical signs. The presence of Bernard\u2013Horner syndrome and hand pain accurately indicated avulsion of the lower roots in 93.7% of the patients. Computed tomography myelography accurately predicted the condition of the lower roots in 100% of the cases. Total avulsion injury was observed in five cases (16%). The lower roots were avulsed in 94% of the cases. The C-5 and C-6 roots were grafted 40 times, and a suitable root stump for grafting lay in a retroscalenic position in 18 (45%) of the 40 cases.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Preoperative assessment based on clinical examination and CT myelography allowed correct surgical planning in more than 90% of the cases.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2006.105.6.835","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:41:37Z","timestamp":1201178497000},"page":"835-842","source":"Crossref","is-referenced-by-count":48,"title":["Use of clinical signs and computed tomography myelography findings in detecting and excluding nerve root avulsion in complete brachial plexus palsy"],"prefix":"10.3171","volume":"105","author":[{"given":"Jayme Augusto","family":"Bertelli","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nossa Senhora da Concei\u00e7\u00e3o Hospital, Tubar\u00e3o; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florian\u00f3polis; and Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubar\u00e3o, Santa Catarina, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Fl\u00e1vio","family":"Ghizoni","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nossa Senhora da Concei\u00e7\u00e3o Hospital, Tubar\u00e3o; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florian\u00f3polis; and Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubar\u00e3o, Santa Catarina, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1050835","series-title":"Thompson\u2019s Core Textbook of Anatomy","first-page":"474","year":"1990"},{"key":"b2-1050835","series-title":"Rev Chir Orthop","first-page":"665","article-title":"[Total paralysis of the brachial plexus. 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