Muscle preservation using an implantable electrical system after nerve injury and repair

Abstract

The value of continuous electrical stimulation of denervated muscles after nerve injury and repair has been clearly shown in a series of laboratory experiments in three animal models. This experimental background, which showed improved muscle preservation and better functional results, evolved into a clinical study that included 15 patients with peripheral nerve injuries in the upper extremities, 3 patients with brachial plexus injuries, and three patients with facial nerve paralysis. Improved functional results were obtained using this implantable system, which were similar to those achieved with the animal experiments. All patients had muscle stimulation for extended periods ranging from 127 to 346 days. Analysis of the results showed satisfactory nerve regeneration on clinical examination and with electromyographic studies. Functional muscle analysis varied somewhat from patient to patient, but every patient had a satisfactory to excellent recovery. The results from this study have clearly shown the benefits of continuous muscle stimulation using an implantable electrical system after nerve injury and repair expansion of the project to a larger patient cohort is indicated.

Regeneration of skeletal muscle

“…A key approach to developing differentiated and functional skeletal muscle tissue is electrical stimulation during myogenesis, either through innervation or by artificial methods. The expression of desmin, myosin heavy chain and other myogenic factors can be increased significantly by electrical stimulation of the repairing muscle (Flaibani et al 2009;Nicolaidis and Williams 2001;Park et al 2008;Sasaki et al 2007;Serena et al 2008). This type of stimulation is thought to mimic neuronal activity and has achieved success, both in vitro and in vivo, for enhancing myotube formation and contractile force.…”

A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems

“…A final issue with percutaneous electrodes is that muscle contractions may result in eventual breakage, although these problems have become less frequent with the improvement of electrodes and lead wires ( Onishi et al, 2000 ) . Electrical stimulation delivered through intramuscular or epimysial electrodes has been applied for maintenance of denervated muscles after plexus or peripheral nerve injuries, in order to avoid disuse atrophy ( Nicolaidis and Williams, 2001 ) . In this situation, voltage pulses should be higher and of longer duration than for activation of innervated muscles so as to directly excite the muscle fiber membrane.…”

Outcome following Nerve Repair of High Isolated Clean Sharp Injuries of the Ulnar Nerve

“…So, finally 46 articles were read in detail. Of the 46 articles, we excluded based on type of injury [42], [10], [13], [11], [4], [12], [43], [44], method of repair [45], [46], [47], [19], [18], [15], [48], level of injury [49], [50], [7], [51], [25], [9], [8], [6], [52], [53], [54], [55], [56], [57], [58], [59], [60], [61], [62], [63], [64], not isolated ulnar nerve injuries [65], [41].…”