## 4 Discussion  
As TBPIs usually require several surgical techniques, the best results are usually obtained in non-complex, simple C5-C6 lesions by performing flexion of the forearm against the arm [2]. It is common that the patient would also need surgery for the other associated deficits, such as restoring opposition of the thumb [2; 11]. From our experience, although this is a modifiable morbidity factor, in our region at least, some tBPI patients travel to different medical centers throughout the country, see different surgeons, and even receive interventions with very poor history documentation during long periods. It is not rare that a patient would not have the ability to give a correct history and, also, throughout the year, keeping track of some interventions is not always possible. On the other hand, compliance with rehabilitation protocols can also be reduced, related to long periods or, in our case, even to specific intervals. It is also difficult to gather a significant numerical group of patients to follow up at a given amount of time. Addressability issues, such as those during the SARS-CoV2 pandemic, also limited the follow-up of many patients with various types of brachial plexus lesions. Therefore, a single-center and relatively nonrandomized retrospective study acts as a major limitation. Needless to say, the number of tBPIs that were treated with surgical Oberlin procedures under these circumstances is relatively low to gather in our region, and quite challenging as an interdisciplinary approach. Accordingly, the small sample size is a mentionable limitation. The small group also required all patients to be right-handed. Our preoccupations related to neuroplasticity in brachial plexus lesions started from [PERSON]'s concept of the hand as an extension of the brain, as synaptic reorganization in the sensory-motor cortex enormously relies on the tactical experiences of the hand [5]. In this context, defective reinnervation and even the phantom-limb syndrome actually suggest a profound cortical reorganization, thus successful surgical procedures in the upper limb highly depend on neuroplasticity [4; 5]. Earlier, [PERSON] et al. proved the brain's reorganization patterns in 12 monkeys with transection of the ulnar and radial nerves. Cortical reorganization by analysis of the motor response in only one nerve-innervated limb (the median nerve) was assessed up to 1 and a half years, showing neuronal aggregates activated by inputs from each nerve [12]. \begin{table}
\begin{tabular}{l c c c} \hline \hline \multirow{2}{*}{**Parameters**} & \multicolumn{2}{c}{**Initial Evaluation**} & \multicolumn{2}{c}{**Final Evaluation**} \\  & \(n\) = 5 Patients That_ & \(n\) = 5 Patients That_ & \\  & **Discontinued** & **Discontinued** & \(p\) \\  & **Rehabilitation** & **Rehabilitation** & \\ \hline MEP right side of the brain & & & \\ (ms) & 18.760 \(\pm\) 2.283 & 18.900 \(\pm\) 2.376 & 0.9266 \\ MEP left side of the brain & & & \\ (ms) & 22.600 \(\pm\) 12.766 & 27.600 \(\pm\) 1.458 & 0.4096 \\ MEP right biceps brachii & & & \\ (ms) & 13.220 \(\pm\) 18.327 & 32.820 \(\pm\) 4.549 & 0.0488 \\ MEP left biceps brachii & & & \\ (ms) & & & \\ MEP right cervical side & & & \\ (ms) & 14.080 \(\pm\) 19.486 & 34.800 \(\pm\) 4.953 & 0.0501 \\ MEP left cervical side & & & \\ (ms) & 16.460 \(\pm\) 1.341 & 17.120 \(\pm\) 1.465 & 0.4787 \\ CMAP radial nerve & & & \\ (mA) & & & \\ SNAP radial nerve & & & \\ (\(\mu\)A) & 0.960 \(\pm\) 0.288 & 1.500 \(\pm\) 0.458 & 0.0562 \\ MRC & & 1.200 \(\pm\) 0.447 & 1.400 \(\pm\) 0.548 & 0.5447 \\ DQMS & & & \\ (kgF) & & & \\ \hline \hline \end{tabular}
\end{table} 
Table 5: Initial and final evaluation of the patients that discontinued rehabilitation. [PERSON] et al. assessed four patients with cervical root avulsions after intercostal to musculocutaneous nerve anastomosis. Six months after the surgery, motor unit action potentials were recorded from the operated biceps while the patient was doing a profound inspiration [13].