Axonal supercharging technique using reverse end-to-side neurorrhaphy in peripheral nerve repair: an experimental study in the rat model

Fujiwara, Toshihiro; Matsuda, Ken; Kubo, Tateki; Tomita, Koichi; Hattori, Reiji; Masuoka, Takeshi; Yano, Kenji; Hosokawa, Ko

doi:10.3171/jns-07/10/0821

Cited by 56 publications

(42 citation statements)

References 22 publications

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“…To simplify this RETS nomenclature, we prefer the term supercharge end-to-side (SETS) 49 , in a way similar to the vascular description 50 . In 1988, Terzis described this in a clinical report and termed it the babysitter procedure.…”

Section: Discussionmentioning

confidence: 99%

Supercharge Nerve Transfer to Enhance Motor Recovery: A Laboratory Study

Farber¹,

Glaus²,

Moore³

et al. 2013

The Journal of Hand Surgery

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Purpose To investigate the ability of a supercharge end-to-side (SETS) nerve transfer to augment the effect of regenerating native axons in an incomplete rodent sciatic nerve injury model. Methods Fifty-four Lewis rats were randomized to 3 groups. The first group was an incomplete recovery model (IRM) of the tibial nerve complemented with a SETS transfer from the peroneal nerve (SETS-IRM). The IRM consisted of tibial nerve transection and immediate repair using a 10mm fresh tibial isograft to provide some, but incomplete, nerve recovery. The 2 control groups were IRM alone and SETS alone. Nerve histomorphometry, electron microscopy, retrograde labeling, and muscle force testing were performed. Results Histomorphometry of the distal tibial nerve showed significantly increased myelinated axonal counts in the SETS-IRM group compared to the IRM and SETS groups at 5 and 8 weeks. Retrograde labeling at 8 weeks confirmed increased motoneuron counts in the SETS-IRM group. Functional recovery at 8 weeks showed a significant increase in muscle specific force in the SETS-IRM group compared to the IRM group. Conclusions A SETS transfer enhanced recovery from an incomplete nerve injury as determined by histomorphometry, motoneuron labeling within the spinal cord, and muscle force measurements. Clinical Relevance A SETS distal nerve transfer may be useful in nerve injuries with incomplete regeneration such as proximal Sunderland II or III degree injuries, where long regeneration distance yields prolonged time to muscle reinnervation and suboptimal functional recovery.

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Section: Discussionmentioning

confidence: 99%

Supercharge Nerve Transfer to Enhance Motor Recovery: A Laboratory Study

Farber¹,

Glaus²,

Moore³

et al. 2013

The Journal of Hand Surgery

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“…The concept of reverse end-to-side nerve suture with axonal supercharging of the recipient nerve has been also experimentally investigated in rat model with complete and incomplete sciatic nerve injuries. These studies demonstrated that functional recovery after peripheral nerve injury was promoted by axonal augmentation [45–47]. Nevertheless, to our knowledge, no clinical applications of such technique have been reported up to now.…”

Section: Clinical Applicationsmentioning

confidence: 99%

Clinical Applications of End-to-Side Neurorrhaphy: An Update

Tos

Colzani

Ciclamini

et al. 2014

BioMed Research International

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End-to-side neurorrhaphy constitutes an interesting option to regain nerve function after damage in selected cases, in which conventional techniques are not feasible. In the last twenty years, many experimental and clinical studies have been conducted in order to understand the biological mechanisms and to test the effectiveness of this technique, with contrasting results. In this updated review, we consider the state of the art about end-to-side coaptation, focusing on all the current clinical applications, such as sensory and mixed nerve repair, treatment of facial palsy, and brachial plexus injuries and painful neuromas management.

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“…Th e regenerating axons were augmented and well myelinated by using this technique (Isaacs et al 2005). Additional study showed better sensory and motor functional recovery than with transaction and repair of the right sciatic nerve without augmentation by RETS technique (Fujiwara et al 2007). Th erefore we postulate that coaptation of AIN in RETS fashion provides earlier motor end-plate reinnervation to " babysit " the target muscle and distal nerve stump, as well as augments regenerating axons by the donor and original nerve.…”

Section: Theoretical Fundamental Of the Hypothesismentioning

confidence: 94%

Early nerve protection with anterior interosseous nerve in modified end-to-side neurorrhaphy repairs high ulnar nerve injury: a hypothesis of a novel surgical technique

Zhang

Yin

et al. 2013

Artificial Cells, Nanomedicine, and Biotechnology

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High ulnar nerve injuries frequently result in poor functional recovery. The prolonged denervation of target muscle largely accounts for the poor functional outcome. There are no approved effective treatments for high ulnar nerve injuries. However, the technique of reverse end-to-side (RETS) offers novel possibilities. The RETS nerve transfer not only provides earlier motor end-plate reinnervation to "babysit" the target muscle until native axons from the original high nerve regenerate, but also augments the regenerating axons. We postulate that coaptation of anterior interosseous nerve to the side of distal ulnar nerve by RETS technique could be an effective therapeutic intervention for high ulnar nerve injuries in human.

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Axonal supercharging technique using reverse end-to-side neurorrhaphy in peripheral nerve repair: an experimental study in the rat model

Abstract: The reverse end-to-side neurorrhaphy technique could be useful in peripheral nerve repair.

Cited by 56 publications

References 22 publications

Supercharge Nerve Transfer to Enhance Motor Recovery: A Laboratory Study

Supercharge Nerve Transfer to Enhance Motor Recovery: A Laboratory Study

Clinical Applications of End-to-Side Neurorrhaphy: An Update

Early nerve protection with anterior interosseous nerve in modified end-to-side neurorrhaphy repairs high ulnar nerve injury: a hypothesis of a novel surgical technique

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