Limitations of nerve repair of segmental defects using acellular conduits

Yerko A. Berrocal, Vania W. Almeida, Allan D. Levi

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient underwent reexploration, excision of the "regenerated cable," and rerepair of the ulnar nerve with sural nerve autografts. Histology of the cable demonstrated minimal axonal regeneration at the midpoint of the repair. At the 6- and 12-month follow-ups of the sural nerve graft repair, clinical and electrophysiological evidence of both sensory and motor reinnervation of the ulnar nerve and associated hand muscles was demonstrated. In this report, the authors describe a single case of failed acellular nerve allograft and correlate the results with basic science and human studies reporting length and diameter limitations in human nerve repair utilizing grafts or conduits devoid of viable Schwann cells.

Original languageEnglish (US)
Pages (from-to)733-738
Number of pages6
JournalJournal of neurosurgery
Volume119
Issue number3
DOIs
StatePublished - Sep 1 2013

Keywords

  • Conduit
  • Nerve injury
  • Peripheral nerve
  • Repair
  • Transplantation
  • Tube

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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