Repairing Damaged Nerves:

When a spinal nerve or peripheral nerve is physically separated, it becomes less likely that the nerve fiber will regenerate to its target organ.  Microneurosurgery can be considered to place a nerve graft or to insert a synthetic material to create an artificial scaffold to redirect recovering nerve fibers.  The process of surgically reconnecting nerve often requires that the surgeon wait until the scarring process has slowed or stopped. 

There are many obstacles to reconnecting a nerve.  One of the most common obstacles is the presence of thick scar tissue and altered blood flow to the region.  There is no way for a neurosurgeon to match up each individual nerve fiber.  Other obstacle to appropriate recovery or significant recovery with peripheral nerve or spinal nerve intervention is the health of the target tissue or organ.  If the tissue, which is normally connected to the nerve, goes without its nerve supply long enough, it will undergo degenerative changes and/or atrophic changes.  For example, if a muscle loses its nerve input for many months, it may become unresponsive to reinnervation.  No matter what is done to bring nerve supply back to the muscle, the muscle fibers may have already undergone too much degeneration to allow for a full recovery.  It becomes important to reevaluate a patient during the nerve recovery process and to determine whether the recovery is taking place as expected.  Specialized nerve studies and needle EMG studies can be performed to help the pattern of neurological and related tissue re-recovery. 

Early detection of an abnormal pattern of neurological recovery, may allow adequate time for additional therapeutic intervention with a new or different approach.  Specialized forms of imaging such as neurosonography or magnetic resonance Neurography (MRN) may also help determine whether a nerve is intact or disrupted and also help to follow the pattern of recovery.