Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases

Kandenwein, J. A.; Kretschmer, Thomas; Engelhardt, Martin; Richter, Hans-Peter; Antoniadis, Gregor

doi:10.3171/jns.2005.103.4.0614

Cited by 73 publications

(57 citation statements)

References 34 publications

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“…In Thailand, Limthongthang et al, 11 reported that 91% of the Traumatic BPI was due to RTA and 82% were due to motorbike accidents. In Germany, Kandenwein et al, 9 advocated that 81% of the traumatic BPI was due to RTA while 65% of these were because of motorbike accidents. In our study, we found that RTA accounts for72% of the traumatic BPI while 92% of these were because of motor bike accidents.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

Elqazaz¹,

Elsebaey²

2016

Egyptian Spine Journal

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Background Data: Improving the knowledge about the epidemiology of the traumatic brachial plexus injuries (BPI) helps in providing an appropriate assessment and management of these cases. This issue is important especially in those injuries that have much burden on the individual and national income. Purpose: To evaluate the epidemiological, clinical, and outcome of traumatic brachial plexus injuries in Suez Canal University and Damanhur Medical National Institute Hospitals over 2 years. Study Design: A retrospective descriptive clinical case study. Patients and Methods: Eighteen patients had traumatic brachial plexus injury were operated by our team from January 2014 to December 2015. Data regarding the age, sex, causes of BPI, patterns of injury, surgical approaches, surgical procedures and recovery outcome were collected. Results: All the patients were males with mean age 31 years, 72% encountered road traffic accidents (RTA), and 90% were because of motorbike accidents. 60% showed upper BPI. Neurolysis, nerve grafting and nerve transfer were the surgical procedures that were followed. Functional recovery had been achieved in about 61% of the study population. Conclusion: Our study gives insight into epidemiological aspects of the BPI in Egypt and the role of our new center in the management of those injuries. Taking into consideration the small number of the study population, our results were more or less similar published literatures. (2016ESJ112)

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Section: Discussionmentioning

confidence: 99%

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

Elqazaz¹,

Elsebaey²

2016

Egyptian Spine Journal

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“…Short gaps (few mm), can be repaired by direct suture of the proximal and the distal stumps with end-to-end coaptation and epineural suturing. The most common treatment for longer nerve gaps is surgical repair using autologous nerve grafts (autografts) (Deumens et al, 2010;Kandenwein, Kretschmer, Engelhardt, Richter, & Antoniadis, 2005). Autografts have shown high efficacy in inducing nerve regeneration because they provide to the regenerating axons a natural guidance channel with SC surrounded by their basal lamina, allowing appropriate alignment of outgrowing axons (Deumens et al, 2010).…”

Section: Nrg1 To Promote Nerve Repair Peripheral Nerve Injury and Repairmentioning

confidence: 99%

Neuregulin 1 Role in Schwann Cell Regulation and Potential Applications to Promote Peripheral Nerve Regeneration

Gambarotta

Fregnan

Gnavi

et al. 2013

International Review of Neurobiology

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Neuregulin 1 (NRG1) is a multifunctional and versatile protein: its numerous isoforms can signal in a paracrine, autocrine or juxtacrine manner, playing a fundamental role during the development of the peripheral nervous system and during the process of nerve repair, suggesting that the treatment with NRG1 could improve functional outcome following injury. Accordingly, the use of NRG1 in vivo has already yielded encouraging results.The aim of this review is to focus on the role played by the different NRG1 isoforms during peripheral nerve regeneration and remyelination and to identify good candidates to be used for the development of tissue engineered medical devices delivering NRG1, with the final goal to promote better nerve repair.

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“…Animal model studies have shown that motor nerve grafts induce axons to regenerate significantly longer distances than sensory nerve grafts [33,99]. Typically such studies involved the use of motor grafts harvested another animal of the same or different species, i.e.…”

Section: Immunosuppressantsmentioning

confidence: 99%

“…None of these techniques induces more effective axon regeneration than autologous sensory nerve grafts [20,31,[185][186][187][188]. Therefore, despite their significant limitation in inducing axon regeneration, sensory nerve grafts remain the "gold standard" for clinical peripheral nerve repair [3,99,110,106,148,[189][190][191][192][193].…”

Section: Alternative Tested Techniques For Bridging Nerve Gapsmentioning

confidence: 99%

“…Although regeneration is good to excellent for bridged nerve gaps <2 cm in length [95][96][97][98][99][100][101], it becomes increasingly limited as bridged gaps reach 4 cm in length [97,100], and decreases significantly with increasing graft length, with few axons regenerating across grafts of 8 cm in length [95,98,99,102], and no regeneration is seen for gaps more than 10 cm in length [30,[102][103][104][105][106].…”

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confidence: 99%

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Promoting Axon Regeneration and Neurological Recovery Following Traumatic Peripheral Nerve Injuries

Kuffler¹

2015

Int J Neurorehabilitation Eng

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Repairing Peripheral Nerves following Traumas Nerve crushWithin several days of crushing a peripheral nerve, the injured axons begin to regenerate through their distal pathway until they reach their original targets with which they restore neurological function. The larger the number of axons that regenerate through the distal nerve, the greater the extent of neurological recovery [1][2][3]. The number of axons that regenerate, and thus neurological recovery, is influenced by the physiological state of the distal denervated nerve pathway [4][5][6][7].Following a peripheral nerve crush, the injured axons begin to regenerate within 2 days of injury [8]. They may regenerate to their targets through their original pathway in association with and promoted by its Schwann cells, the neurotrophic factors they release, and the Schwann cell extracellular matrix [1,4,[9][10][11][12][13][14]. Thus, the distal nerve provides a simple means for promoting and directing the regenerating axons to their original targets [15][16][17][18]. However, when a nerve has a gap, the gap must be bridged with a material that is permissive to and promotes axon regeneration across the entire gap to reach the distal nerve stump, through which the axons must then be able to regenerate.The Schwann cells in the denervated distal nerve release neurotrophic factors that promote axon regeneration, but also release extracellular matrix components that promote and inhibit axon regeneration [19][20][21][22][23][24][25][26]. Thus, regeneration through the distal nerve is a balance of the influences of factors that both promote and inhibit regeneration. If the Schwann cells are present, such as after a simple nerve crush, virtually 100% of the axons regenerate and they innervate all the denervated synaptic sites. If the Schwann cells within the distal nerve pathway are killed, leaving only the extracellular matrix intact, the number of axons that regenerates to their targets decreases by 94%. This is because the factors required to trigger the regenerating axons to branch at extracellular matrix branch points are missing, axons do not branch, and therefore each axon reinnervates only a single denervated muscle fiber. Thus, Schwann cells along the distal nerve pathway and a AbstractFollowing a peripheral nerve crush, or when a peripheral the nerve is transected and the nerve stumps anastomosed, neurological recovery is generally excellent. This is because the axons merely have to regenerate through the distal portion of the nerve through the existing extracellular matrix of the denervated Schwann cells that direct and promote them to their distant denervated motor and sensory targets. However, when a length of a peripheral nerve is destroyed, and anastomosis is not possible, the standard surgical repair technique is to graft a length/s of autologous sensory nerve into the gap. Neurological recovery is generally good if the nerve gap is <2 cm in length, the repair is performed <4 months post trauma, and the patients are <25 years of age. Because the nerve ...

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Surgical interventions for traumatic lesions of the brachial plexus: a retrospective study of 134 cases

Abstract: The results of neurosurgical interventions for brachial plexus lesions are satisfactory, especially when the operation is performed between 3 and 6 months after trauma.

Cited by 73 publications

References 34 publications

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

Traumatic Brachial Plexus Injuries: Epidemiological Study at two Egyptian Centers over 2 Years

Neuregulin 1 Role in Schwann Cell Regulation and Potential Applications to Promote Peripheral Nerve Regeneration

Promoting Axon Regeneration and Neurological Recovery Following Traumatic Peripheral Nerve Injuries

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