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[Development of peripheral nerve surgery]

M Sames1

  • 1Neurochirurgické oddĕlení, Masarykova nemocnice, Ustí nad Labem.

Rozhledy V Chirurgii : Mesicnik Ceskoslovenske Chirurgicke Spolecnosti
|June 12, 1998
PubMed
Summary
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Peripheral nerve surgery has evolved from basic mechanical repairs to advanced microsurgical techniques. Current research focuses on neurotrophism, exploring new methods to enhance nerve regeneration beyond current clinical applications.

Area of Science:

  • Neurology
  • Surgical Innovation
  • Regenerative Medicine

Context:

  • The review details the historical progression of peripheral nerve surgery (PN).
  • It analyzes the last 40 years, dividing it into mechanical, biological, and neurotrophic stages.
  • Early PN repair lacked magnification, leading to suboptimal reinnervation outcomes.

Purpose:

  • To provide a comprehensive overview of peripheral nerve surgery development.
  • To analyze the distinct eras influencing surgical outcomes and techniques.
  • To highlight the evolution from mechanical to biological and neurotrophic approaches in PN repair.

Summary:

  • The mechanical period (WWII-1960s) saw basic repairs without microscopes, yielding poor results.
  • The biological period introduced microsurgery and autotransplantation, improving outcomes but limited by nerve anatomy.

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  • The neurotrophic era, spurred by nerve growth factor (NGF), explores new regenerative strategies, though microsuture and grafting remain current standards.

    • Impact:

    • Microsurgical techniques significantly improved peripheral nerve repair outcomes.
    • Understanding nerve anatomy and biological responses revolutionized surgical approaches.
    • Ongoing research into neurotrophism promises future non-surgical regeneration methods, though microsurgery remains the gold standard for nerve reconstruction.