Benefits and risks

Benefits and risks

There is not much evidence about how well the procedure works in the long term, and there is evidence that it can cause breathing problems. However, people with brachial plexus injury are often very disabled, and there are very few treatment options, so NICE decided that the procedure can be used in the NHS.

The 7 studies that NICE looked at involved a total of 340 patients.

Generally, they showed the following benefits:

  • A year after the procedure, around 30% of patients had got back some arm muscle strength.

  • After 2 years, around 80–90% of patients had got back some arm muscle strength.

  • Recovery was better in younger patients (aged under 40 years), and those who had the procedure within a year after the injury.

The studies showed that the risks of phrenic nerve transfer included:

  • Changes to the position, loss of function, or reduction in movement of the diaphragm, which led to shortness of breath and difficulty breathing during physical activity in most patients.

  • Reduced lung functions (such as the total amount of air a person can take in).

NICE was also told about some other possible risks: chest deformity, hernia, lung collapse, poor control of the arm muscles after the procedure, and the transferred nerve not attaching to the arm muscles.

If you want to know more about the studies see the guidance. Ask your health professional to explain anything you don't understand.

Questions to ask your health professional

  • What does the procedure involve?

  • What are the benefits I might get?

  • How good are my chances of getting those benefits? Could having the procedure make me feel worse?

  • Are there alternative procedures?

  • What are the risks of the procedure?

  • Are the risks minor or serious? How likely are they to happen?

  • What care will I need after the procedure?

  • What happens if something goes wrong?

  • What may happen if I don't have the procedure?

  • Information Standard