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Combining Peripheral Nerve Grafting and Matrix Modulation to Repair the Injured Rat Spinal Cord
Published on: November 20, 2009
Bridging defects: autologous nerve grafts.
1Millesi Center for the Surgery of Brachial Plexus and Peripheral Nerve Lesions, Vienna Private Clinic, Vienna, Austria. millesi@wpk.at
Acta Neurochirurgica. Supplement
|November 8, 2007
Summary
Autologous nerve grafting is a reliable technique for long nerve defects, with minimal donor site morbidity. Alternative methods like tubulisation should supplement, not replace, nerve grafts when autografts are insufficient.
Area of Science:
- Neurosurgery
- Regenerative Medicine
- Peripheral Nerve Repair
Background:
- Autologous nerve grafting has a long history, with early attempts yielding limited success.
- The interfascicular nerve grafting technique, developed in the 1960s, offers reliable bridging of extensive nerve defects.
- Donor site morbidity associated with autografts is minimal when appropriate precautions are taken.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of autologous nerve grafting.
- To discuss the role of alternative techniques in managing large nerve defects.
- To emphasize the supplementary role of tubulisation in nerve reconstruction.
Main Methods:
- Review of personal experience spanning over 40 years in nerve grafting.
- Analysis of donor site morbidity in relation to autologous nerve grafting.
- Assessment of the limitations of autografts in extensive defects, such as brachial plexus injuries.
Main Results:
- Autologous nerve grafting, particularly the interfascicular technique, provides predictable results for long nerve defects.
- Minimal donor site morbidity is achievable with careful surgical technique.
- The quantity of autografts is often insufficient for vast defects, necessitating alternative strategies.
Conclusions:
- Autologous nerve grafts remain a gold standard for peripheral nerve repair.
- Donor site morbidity does not preclude the use of autologous nerve grafts.
- Tubulisation and other alternative techniques should be considered as adjuncts to autologous nerve grafting, especially in cases of extensive nerve loss.
