Cargando…

Restoration of Neurological Function Following Peripheral Nerve Trauma

Following peripheral nerve trauma that damages a length of the nerve, recovery of function is generally limited. This is because no material tested for bridging nerve gaps promotes good axon regeneration across the gap under conditions associated with common nerve traumas. While many materials have...

Descripción completa

Detalles Bibliográficos
Autores principales: Kuffler, Damien P., Foy, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084579/
https://www.ncbi.nlm.nih.gov/pubmed/32155716
http://dx.doi.org/10.3390/ijms21051808
_version_ 1783508754504876032
author Kuffler, Damien P.
Foy, Christian
author_facet Kuffler, Damien P.
Foy, Christian
author_sort Kuffler, Damien P.
collection PubMed
description Following peripheral nerve trauma that damages a length of the nerve, recovery of function is generally limited. This is because no material tested for bridging nerve gaps promotes good axon regeneration across the gap under conditions associated with common nerve traumas. While many materials have been tested, sensory nerve grafts remain the clinical “gold standard” technique. This is despite the significant limitations in the conditions under which they restore function. Thus, they induce reliable and good recovery only for patients < 25 years old, when gaps are <2 cm in length, and when repairs are performed <2–3 months post trauma. Repairs performed when these values are larger result in a precipitous decrease in neurological recovery. Further, when patients have more than one parameter larger than these values, there is normally no functional recovery. Clinically, there has been little progress in developing new techniques that increase the level of functional recovery following peripheral nerve injury. This paper examines the efficacies and limitations of sensory nerve grafts and various other techniques used to induce functional neurological recovery, and how these might be improved to induce more extensive functional recovery. It also discusses preliminary data from the clinical application of a novel technique that restores neurological function across long nerve gaps, when repairs are performed at long times post-trauma, and in older patients, even under all three of these conditions. Thus, it appears that function can be restored under conditions where sensory nerve grafts are not effective.
format Online
Article
Text
id pubmed-7084579
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-70845792020-03-24 Restoration of Neurological Function Following Peripheral Nerve Trauma Kuffler, Damien P. Foy, Christian Int J Mol Sci Review Following peripheral nerve trauma that damages a length of the nerve, recovery of function is generally limited. This is because no material tested for bridging nerve gaps promotes good axon regeneration across the gap under conditions associated with common nerve traumas. While many materials have been tested, sensory nerve grafts remain the clinical “gold standard” technique. This is despite the significant limitations in the conditions under which they restore function. Thus, they induce reliable and good recovery only for patients < 25 years old, when gaps are <2 cm in length, and when repairs are performed <2–3 months post trauma. Repairs performed when these values are larger result in a precipitous decrease in neurological recovery. Further, when patients have more than one parameter larger than these values, there is normally no functional recovery. Clinically, there has been little progress in developing new techniques that increase the level of functional recovery following peripheral nerve injury. This paper examines the efficacies and limitations of sensory nerve grafts and various other techniques used to induce functional neurological recovery, and how these might be improved to induce more extensive functional recovery. It also discusses preliminary data from the clinical application of a novel technique that restores neurological function across long nerve gaps, when repairs are performed at long times post-trauma, and in older patients, even under all three of these conditions. Thus, it appears that function can be restored under conditions where sensory nerve grafts are not effective. MDPI 2020-03-06 /pmc/articles/PMC7084579/ /pubmed/32155716 http://dx.doi.org/10.3390/ijms21051808 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Kuffler, Damien P.
Foy, Christian
Restoration of Neurological Function Following Peripheral Nerve Trauma
title Restoration of Neurological Function Following Peripheral Nerve Trauma
title_full Restoration of Neurological Function Following Peripheral Nerve Trauma
title_fullStr Restoration of Neurological Function Following Peripheral Nerve Trauma
title_full_unstemmed Restoration of Neurological Function Following Peripheral Nerve Trauma
title_short Restoration of Neurological Function Following Peripheral Nerve Trauma
title_sort restoration of neurological function following peripheral nerve trauma
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084579/
https://www.ncbi.nlm.nih.gov/pubmed/32155716
http://dx.doi.org/10.3390/ijms21051808
work_keys_str_mv AT kufflerdamienp restorationofneurologicalfunctionfollowingperipheralnervetrauma
AT foychristian restorationofneurologicalfunctionfollowingperipheralnervetrauma