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01-09-2017 | Review Article

An update on addressing important peripheral nerve problems: challenges and potential solutions

Authors: Wilson Z. Ray, Mark A. Mahan, Danzhu Guo, Danqing Guo, Michel Kliot

Published in: Acta Neurochirurgica | Issue 9/2017

Abstract

From time to time it is thoughtful and productive to review a medical field and reflect upon what are the major issues that need to be addressed and what is being done to do so. This review article is not meant to be all-inclusive but rather focuses on four evolving areas in the field of peripheral nerve disorders and treatments: (1) nerve surgery under ultrasound guidance using a new ultra-minimally invasive thread technique; (2) evolving magnetic resonance imaging (MRI) and ultrasound imaging techniques that are helping to both diagnose and treat a variety of peripheral nerve problems including entrapment neuropathies, traumatic nerve injuries, and masses arising from nerves; (3) promoting recovery after nerve injury using electrical stimulation; and (4) developing animal models to reproduce a severe nerve injury (neurotmetic grade in continuity) that requires a surgical intervention and repair. In each area we first describe the current challenges and then discuss new and emerging techniques and approaches. It is our hope that this article will bring added attention and resources to help better address peripheral nerve problems that remain a challenge for both patients and physicians.

Guo D, Tang Y, Ji Y, Sun T, Guo J, Guo D (2015) A non-scalpel technique for minimally invasive surgery: percutaneously looped thread transection of the transverse carpal ligament. Hand (N Y) 10:40–48CrossRef

Guo D, Guo D, Guo J, Malone DG, Wei N, McCool LC (2016) A cadaveric study for the improvement of thread carpal tunnel release. J Hand Surg 41:e351–e357CrossRef

Guo D, Guo D, Guo J, Schmidt SC, Lytie RM (2016) A clinical study of the modified thread carpal tunnel release (TCTR). Hand. doi:10.1177/1558944716668831

Hayes CE, Tsuruda JS, Mathis CM, Maravilla KR, Kliot M, Filler AG (1997) Brachial plexus: MR imaging with a dedicated phased array of surface coils. Radiology 203:286–289CrossRefPubMed

Britz GW, Haynor DR, Kuntz C, Goodkin R, Gitter A, Maravilla K, Kliot M (1996) Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings. Neurosurgery 38:458–465 discussion 465 PubMed

Jarvik JG, Comstock BA, Heagerty PJ, Haynor DR, Fulton-Kehoe D, Kliot M, Franklin GM (2008) Magnetic resonance imaging compared with electrodiagnostic studies in patients with suspected carpal tunnel syndrome: predicting symptoms, function, and surgical benefit at 1 year. J Neurosurg 108:541–550CrossRefPubMed

Aagaard BD, Lazar DA, Lankerovich L, Andrus K, Hayes CE, Maravilla K, Kliot M (2003) High-resolution magnetic resonance imaging is a noninvasive method of observing injury and recovery in the peripheral nervous system. Neurosurgery 53:199–203 discussion 203–204 CrossRefPubMed

Dailey AT, Tsuruda JS, Filler AG, Maravilla KR, Goodkin R, Kliot M (1997) Magnetic resonance neurography of peripheral nerve degeneration and regeneration. Lancet 350:1221–1222CrossRefPubMed

Simon NG, Narvid J, Cage T, Banerjee S, Ralph JW, Engstrom JW, Kliot M, Chin C (2014) Visualizing axon regeneration after peripheral nerve injury with magnetic resonance tractography. Neurology 83:1382–1384CrossRefPubMedPubMedCentral

10.

Gallagher TA, Simon NG, Kliot M (2015) Diffusion tensor imaging to visualize axons in the setting of nerve injury and recovery. Neurosurg Focus 39:E10CrossRefPubMed

11.

Das S, Ganju A, Tiel RL, Kline DG (2007) Tumors of the brachial plexus. Neurosurg Focus 22:E26CrossRefPubMed

12.

Kuntz C, Blake L, Britz G, Filler A, Hayes CE, Goodkin R, Tsuruda J, Maravilla K, Kliot M (1996) Magnetic resonance neurography of peripheral nerve lesions in the lower extremity. Neurosurgery 39:750–756 discussion 756-757 CrossRefPubMed

13.

Singh T, Kliot M (2007) Imaging of peripheral nerve tumors. Neurosurg Focus 22:E6CrossRefPubMed

14.

Kliot T, Ince Y, Tihan T, Wilson M, Kliot M (2013) To grow or not to grow, that is the question. Surg Neurol Int 4:S407–S410CrossRefPubMedPubMedCentral

15.

Broski SM, Johnson GB, Howe BM, Nathan MA, Wenger DE, Spinner RJ, Amrami KK (2016) Evaluation of (18)F-FDG PET and MRI in differentiating benign and malignant peripheral nerve sheath tumors. Skelet Radiol 45:1097–1105CrossRef

16.

Soldatos T, Fisher S, Karri S, Ramzi A, Sharma R, Chhabra A (2015) Advanced MR imaging of peripheral nerve sheath tumors including diffusion imaging. Semin Musculoskelet Radiol 19:179–190CrossRefPubMed

17.

Yuh EL, Jain Palrecha S, Lagemann GM, Kliot M, Weinstein PR, Barbaro NM, Chin CT (2015) Diffusivity measurements differentiate benign from malignant lesions in patients with peripheral neuropathy or plexopathy. AJNR Am J Neuroradiol 36:202–209CrossRefPubMed

18.

Capek S, Amrami KK, Dyck PJ, Spinner RJ (2015) Targeted fascicular biopsy of the sciatic nerve and its major branches: rationale and operative technique. Neurosurg Focus 39:E12CrossRefPubMed

19.

Konofaos P, Terzis JK (2013) FK506 and nerve regeneration: past, present, and future. J Reconstr Microsurg 29:141–148CrossRefPubMed

20.

Labroo P, Ho S, Sant H, Shea J, Gale BK, Agarwal J (2016) Controlled delivery of FK506 to improve nerve regeneration. Shock 46:154–159CrossRefPubMed

21.

Labroo P, Shea J, Sant H, Gale B, Agarwal J (2017) Effect of combining FK506 and neurotrophins on neurite branching and elongation. Muscle Nerve 55(4):570–581CrossRefPubMed

22.

Nemoto K, Williams HB, Nemoto K, Lough J, Chiu RC (1988) The effects of electrical stimulation on denervated muscle using implantable electrodes. J Reconstr Microsurg 4:251–255 257CrossRefPubMed

23.

Williams HB (1996) A clinical pilot study to assess functional return following continuous muscle stimulation after nerve injury and repair in the upper extremity using a completely implantable electrical system. Microsurgery 17:597–605CrossRefPubMed

24.

Williams HB (1996) The value of continuous electrical muscle stimulation using a completely implantable system in the preservation of muscle function following motor nerve injury and repair: an experimental study. Microsurgery 17:589–596CrossRefPubMed

25.

Geremia NM, Gordon T, Brushart TM, Al-Majed AA, Verge VM (2007) Electrical stimulation promotes sensory neuron regeneration and growth-associated gene expression. Exp Neurol 205:347–359CrossRefPubMed

26.

Nix WA, Hopf HC (1983) Electrical stimulation of regenerating nerve and its effect on motor recovery. Brain Res 272:21–25CrossRefPubMed

27.

Roman GC, Strahlendorf HK, Coates PW, Rowley BA (1987) Stimulation of sciatic nerve regeneration in the adult rat by low-intensity electric current. Exp Neurol 98:222–232CrossRefPubMed

28.

Xu J, Gu Y, Shen L (1997) Intraoperative extra strong electrical stimulation in the treatment of peripheral nerve injury. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 11:210–212PubMed

29.

Elzinga K, Tyreman N, Ladak A, Savaryn B, Olson J, Gordon T (2015) Brief electrical stimulation improves nerve regeneration after delayed repair in Sprague Dawley rats. Exp Neurol 269:142–153CrossRefPubMed

30.

Gordon T (2016) Electrical stimulation to enhance axon regeneration after peripheral nerve injuries in animal models and humans. Neurotherapeutics 13:295–310CrossRefPubMedPubMedCentral

31.

Gordon T, Amirjani N, Edwards DC, Chan KM (2010) Brief post-surgical electrical stimulation accelerates axon regeneration and muscle reinnervation without affecting the functional measures in carpal tunnel syndrome patients. Exp Neurol 223:192–202CrossRefPubMed

32.

Gordon T, English AW (2016) Strategies to promote peripheral nerve regeneration: electrical stimulation and/or exercise. Eur J Neurosci 43:336–350CrossRefPubMed

33.

Gordon T, Udina E, Verge VM, de Chaves EI (2009) Brief electrical stimulation accelerates axon regeneration in the peripheral nervous system and promotes sensory axon regeneration in the central nervous system. Motor Control 13:412–441CrossRefPubMed

34.

Willand MP, Nguyen MA, Borschel GH, Gordon T (2016) Electrical stimulation to promote peripheral nerve regeneration. Neurorehabil Neural Repair 30:490–496CrossRefPubMed

35.

Willand MP, Rosa E, Michalski B, Zhang JJ, Gordon T, Fahnestock M, Borschel GH (2016) Electrical muscle stimulation elevates intramuscular BDNF and GDNF mRNA following peripheral nerve injury and repair in rats. Neuroscience 334:93–104CrossRefPubMed

36.

Asensio-Pinilla E, Udina E, Jaramillo J, Navarro X (2009) Electrical stimulation combined with exercise increase axonal regeneration after peripheral nerve injury. Exp Neurol 219:258–265CrossRefPubMed

37.

Gamble P, Stephen M, Mac Ewan M, Ray WZ (2016) Serial assessment of functional recovery following nerve injury using implantable thin-film wireless nerve stimulators. Muscle Nerve 54:1114–1119CrossRefPubMed

38.

MacEwan M, Gamble P, Stephen M, Ray WZ (2017) Therapeutic electrical stimulation of injured peripheral nerve tissue utilizing implantable thin-film wireless nerve stimulators. J Neurosurg 84(2):601–602

39.

Kim DH, Cho YJ, Tiel RL, Kline DG (2003) Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg 98:1005–1016CrossRefPubMed

40.

Brown R, Pedowitz R, Rydevik B, Woo S, Hargens A, Massie J, Kwan M, Garfin SR (1993) Effects of acute graded strain on efferent conduction properties in the rabbit tibial nerve. Clin Orthop Relat Res (296):288–294

41.

Haftek J (1970) Stretch injury of peripheral nerve. Acute effects of stretching on rabbit nerve. J Bone Joint Surg Br 52:354–365PubMed

42.

Kwan MK, Wall EJ, Massie J, Garfin SR (1992) Strain, stress and stretch of peripheral nerve. Rabbit experiments in vitro and in vivo. Acta Orthop Scand 63:267–272CrossRefPubMed

43.

Rydevik BL, Kwan MK, Myers RR, Brown RA, Triggs KJ, Woo SL, Garfin SR (1990) An in vitro mechanical and histological study of acute stretching on rabbit tibial nerve. J Orthop Res 8:694–701CrossRefPubMed

44.

Sunderland S, Bradley KC (1961) Stress-strain phenomena in human peripheral nerve trunks. Brain 84:102–119CrossRef

45.

Wall EJ, Kwan MK, Rydevik BL, Woo SL, Garfin SR (1991) Stress relaxation of a peripheral nerve. J Hand Surg Am 16:859–863CrossRefPubMed

46.

Wall EJ, Massie JB, Kwan MK, Rydevik BL, Myers RR, Garfin SR (1992) Experimental stretch neuropathy. Changes in nerve conduction under tension. J Bone Joint Surg Br 74:126–129PubMed

47.

Dubuisson AS, Kline DG (2002) Brachial plexus injury: a survey of 100 consecutive cases from a single service. Neurosurgery 51:673–682 discussion 682–683CrossRefPubMed

48.

Andrisevic E, Taniguchi M, Partington MD, Agel J, Van Heest AE (2014) Neurolysis alone as the treatment for neuroma-in-continuity with more than 50% conduction in infants with upper trunk brachial plexus birth palsy. J Neurosurg Pediatr 13:229–237CrossRefPubMed

49.

Lin JC, Schwentker-Colizza A, Curtis CG, Clarke HM (2009) Final results of grafting versus neurolysis in obstetrical brachial plexus palsy. Plast Reconstr Surg 123:939–948CrossRefPubMed

50.

Pondaag W, Malessy MJ (2014) Neurolysis and upper trunk brachial plexus birth palsy. J Neurosurg Pediatr 14:322–324CrossRefPubMed

51.

Sunderland S (1968) Nerve injuries and their repair: a critical appraisal. Churchill Livingstone, Edinburgh, pp 558–563

52.

Kline DG (1990) Surgical repair of peripheral nerve injury. Muscle Nerve 13:843–852CrossRefPubMed

53.

Gordon T, Tetzlaff W (2015) Regeneration associated genes decline in chronically injured rat sciatic motoneurons. Eur J Neurosci 42(10):2783–2791CrossRefPubMed

54.

Brushart TM (2011) Nerve repair. Oxford University Press, New YorkCrossRef

55.

Birch R (2011) Surgical disorders of the peripheral nerves. Springer, BerlinCrossRef

56.

Liu CT, Benda CE, Lewey FH (1948) Tensile strength of human nerves; an experimental physical and histologic study. Arch Neurol Psychiatr 59:322–336CrossRef

57.

Denny-Brown D, Doherty MM (1945) Effects of transient stretching of peripheral nerve. Arch Neurol Psychiatr 54:116–129CrossRef

58.

Masand SN, Chen J, Perron IJ, Hammerling BC, Loers G, Schachner M, Shreiber DI (2012) The effect of glycomimetic functionalized collagen on peripheral nerve repair. Biomaterials 33:8353–8362CrossRefPubMedPubMedCentral

Title: An update on addressing important peripheral nerve problems: challenges and potential solutions
Authors: Wilson Z. Ray
Mark A. Mahan
Danzhu Guo
Danqing Guo
Michel Kliot
Publication date: 01-09-2017
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 9/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-017-3203-3

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An update on addressing important peripheral nerve problems: challenges and potential solutions

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