Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.

Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies.
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DOI:
10.1155/2014/698256
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发表时间:
2014
影响因子:
--
通讯作者:
Keating CP
Keating CP
中科院分区:
生物学3区
文献类型:
--
作者:
Grinsell D;Keating CP

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与身体的其他组织不同,周围神经的再生是缓慢的,通常是不完全的。在受伤后接受神经修复的患者中,只有不到一半的人恢复了良好的运动或感觉功能,目前的手术技术与桑德兰60多年前描述的手术技术相似。我们对神经生理学和再生知识的不断增长,远远超过了我们重建受损神经和成功再生运动和感觉功能的外科手术能力。从技术上讲,在神经束水平重建神经是可能的,但在单个轴突水平重建神经是不可能的。最近的手术选择,包括神经转移证明在改善近端神经损伤的结果和实验分子和生物工程策略正在开发,以克服生物障碍,限制患者的恢复承诺。
Unlike other tissues in the body, peripheral nerve regeneration is slow and usually incomplete. Less than half of patients who undergo nerve repair after injury regain good to excellent motor or sensory function and current surgical techniques are similar to those described by Sunderland more than 60 years ago. Our increasing knowledge about nerve physiology and regeneration far outweighs our surgical abilities to reconstruct damaged nerves and successfully regenerate motor and sensory function. It is technically possible to reconstruct nerves at the fascicular level but not at the level of individual axons. Recent surgical options including nerve transfers demonstrate promise in improving outcomes for proximal nerve injuries and experimental molecular and bioengineering strategies are being developed to overcome biological roadblocks limiting patient recovery.
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