Nerve transfer with 3D-printed branch nerve conduits

Abstract

Background Nerve transfer is an important clinical surgical procedure for nerve repair by the coaptation of a healthy donor nerve to an injured nerve. Usually, nerve transfer is performed in an end-to-end manner, which will lead to functional loss of the donor nerve. In this study, we aimed to evaluate the efficacy of 3D-printed branch nerve conduits in nerve transfer. Methods Customized branch conduits were constructed using gelatine-methacryloyl by 3D printing. The nerve conduits were characterized both in vitro and in vivo. The efficacy of 3D-printed branch nerve conduits in nerve transfer was evaluated in rats through electrophysiology testing and histological evaluation. Results The results obtained showed that a single nerve stump could form a complex nerve network in the 3D-printed multibranch conduit. A two-branch conduit was 3D printed for transferring the tibial nerve to the peroneal nerve in rats. In this process, the two branches were connected to the distal tibial nerve and peroneal nerve. It was found that the two nerves were successfully repaired with functional recovery. Conclusions It is implied that the two-branch conduit could not only repair the peroneal nerve but also preserve partial function of the donor tibial nerve. This work demonstrated that 3D-printed branch nerve conduits provide a potential method for nerve transfer.

Recent Advances in Decellularized Matrix-Derived Materials for Bioink and 3D Bioprinting

“…Recently, 3D bioprinting has shown its ability to treat and rebuild nerves. Materials such as PCL [ 100 , 101 ], chitosan, Gel-MA [ 102 , 103 ], gelatin, and PLCL [ 24 ] have been employed in the manufacturing of bioinks for 3D bioprinting to produce nerve guide conduits (NGCs) or patches with distinctive structures and mechanical strength. Reconstructing the nervous system requires good electrical conductivity.…”

Traumatic peripheral nerve injuries: diagnosis and management

“…Synthetic conduits are an appealing alternative; however, they cannot successfully facilitate axonal regeneration over long distances, likely because of the lack of microstructural elements found in native nerve [38]. Newer approaches have focused on customizing nerve guide conduits, such as using 3D printing, and creating synthetic scaffolds infused with neurotrophic factors and lined with Schwann cells to create a favorable microenvironment and facilitate axonal migration along these artificial channels, which may increase the likelihood of successful nerve regeneration [39,40,41 ▪ ,42 ▪▪ ]. Simultaneous fat grafting can provide adipose-derived stem cells, which can differentiate into Schwann-like cells that guide axonal regeneration, protect against scarring and provide a favorable microenvironment with pro-regenerative properties [43].…”

Projection-based 3D printing of multichannel poly(caprolactone) methacrylate nerve guidance conduit for peripheral nerve regeneration

“…3 Moreover, the curative effect of this procedure is unsatisfactory as it offers partial functional recovery. 4 Thus, a synthetic device known as a nerve guidance conduit (NGC) has emerged as a promising alternative for facilitating peripheral nerve regeneration.…”