Different Neurological Approaches to Nerve Repair:

Surgical approach to nerve repair is primarily limited to peripheral nerves and has not been applied to spine nerve roots.  One of the surgical approaches to treating peripheral nerve compromises is to perform a nerve graft.  This requires harvesting a portion of a nerve from another location in the body and placing it across the damaged site of a nerve.  One of the most common nerves utilized for this purpose is the sural nerve.  The sural nerve represents one of the more expendable nerves in the body due to its limited function and easy accessibility.  It also represents one of the longest nerve fibers in the body and does not have connection to muscle.  It only contributes to sensation of a small area of skin on the outer surface of the ankle.  If a portion of the sural nerve is removed, this will result in a relatively small patch of abnormal sensation along the lateral aspect of the ankle.  There are also some individual nerves in the arms, which could be utilized.

The use of a nerve from the patient’s own body is referred to as an autograft.  An allograft refers to the use of a nerve from another individual’s body.  The use of an autograft reduces the risks of tissue rejection. 

Further progress in the area of nerve repair also includes the use of entubulation conduits, silk based fabrics, filaments and gels type products to promote nerve growth.  These approaches help to redirect healing nerve fibers to the healthy end of a nerve or to their target tissues.  They create an essential framework or scaffold for the development of a new neural sheath.

Further advances in technology will lead to a better understanding of chemical growth factors, which can be applied to speed up nerve re-growth process.  The use of entubulation process and the application of new chemicals should continue to reduce the need for autografts and allografts.