Ran across this study abstract and thought I'd share it. Wish I had access to the full text.
This is the first notice I've read that speaks of possible complications or risks with nerve root re-implantion. I imagine risks are abundent in that type of complex surgery (as I've read about DREZ technique for pain reduction). I wonder if this is what has been holding up the TBPI trials in the UK for the past 2 plus years.
http://www.neurosurgery-online.com/pt/r ... 28!8091!-1
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AN EXPERIMENTAL MODEL OF VENTRAL ROOT REPAIR SHOWING THE BENEFICIAL EFFECT OF TRANSPLANTING OLFACTORY ENSHEATHING CELLS.
EXPERIMENTAL STUDIES
April 2007
Neurosurgery. 60(4):734-741.
Li, Ying Ph.D.; Yamamoto, Mie M.Sc.; Raisman, Geoffrey M.D., Ph.D.; Choi, David M.D., Ph.D.; Carlstedt, Thomas M.D., Ph.D.
Abstract:
OBJECTIVE: A series of published cases show that repair of brachial plexus injuries by reimplantation of avulsed spinal roots can restore a degree of recovery, particularly to the more proximal shoulder and arm musculature in a proportion of patients. There remains, however, some disagreement regarding how far the benefits outweigh the risks of causing further spinal cord damage. Improving the number of motor fibers regenerating into the reimplanted ventral roots may enhance the muscular recovery, possibly extending it to the more useful distal musculature that would restore a degree of wrist and finger functions.
METHODS: This study was based on our previous rat model showing regeneration of severed fibers and resumption of function after transplantation of cultured adult olfactory ensheathing cells into spinal cord injuries and reimplanted dorsal roots.
RESULTS: We now report that olfactory ensheathing cells transplanted at the spinal cord interface of reimplanted S1 ventral roots survive and migrate selectively into the ventral root where they associate intimately with regenerating ventral root fibers. Whereas only approximately 20% of the normal complement of fibers enter roots reimplanted without olfactory ensheathing cells, this increases to 80% in the presence of olfactory ensheathing cell transplants.
CONCLUSION: These observations suggest that transplants of olfactory ensheathing cells could improve the outcome of ventral root repair.
Copyright (C) by the Congress of Neurological Surgeons
VENTRAL ROOT REPAIR SHOWING THE BENEFICIAL EFFECT OF TRANSPLANTING OECs
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Christopher
- Posts: 845
- Joined: Wed Jun 18, 2003 10:09 pm
- Injury Description, Date, extent, surgical intervention etc: Date of Injury: 12/15/02
Level of Injury:
-dominant side C5, C6, & C7 avulsed. C8 & T1 stretched & crushed
BPI Related Surgeries:
-2 Intercostal nerves grafted to Biceps muscle,
-Free-Gracilis muscle transfer to Biceps Region innervated with 2 Intercostal nerves grafts.
-2 Sural nerves harvested from both Calves for nerve grafting.
-Partial Ulnar nerve grafted to Long Triceps.
-Uninjured C7 Hemi-Contralateral cross-over to Deltoid muscle.
-Wrist flexor tendon transfer to middle, ring, & pinky finger extensors.
Surgical medical facility:
Brachial Plexus Clinic at The Mayo Clinic, Rochester MN
(all surgeries successful)
"Do what you can, with what you have, where you are."
~Theodore Roosevelt - Location: Los Angeles, California USA