Nerve Bypass Surgery for Spinal Cord Reconstruction
Spinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve regeneration, reduce complications, and increase quality of life are valuable for these patients. In this study, we aimed to assess ner...
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| Published in | World neurosurgery Vol. 189; pp. e27 - e37 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
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Elsevier Inc
01.09.2024
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| Abstract | Spinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve regeneration, reduce complications, and increase quality of life are valuable for these patients. In this study, we aimed to assess nerve bypass surgery's feasibility and clinical outcomes by transferring the intercostal nerves into the spinal cord.
Eight patients with complete thoracic SCI and delayed presentation more than a year after the injury were analyzed retrospectively. All patients underwent nerve bypass surgery with the transfer of 2 pairs of intercostal nerves from proximal to the injury site to the anterolateral spinal cord, followed by duraplasty with fascia grafting to close the dura.
Six of the 8 (75%) patients demonstrated motor and sensory improvements, based on the American SCI Association score. Three patients demonstrated a limited recovery of motor function that could be independently triggered without ICN initiation. Five patients demonstrated evidence of cerebrospinal fluid leakage after surgery; however, only 1 patient complained of a headache.
Spinal cord bypass surgery is a potential reconstruction method to treat chronic complete thoracic SCI with functional improvements, and is worth further investigation. |
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| AbstractList | Spinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve regeneration, reduce complications, and increase quality of life are valuable for these patients. In this study, we aimed to assess nerve bypass surgery's feasibility and clinical outcomes by transferring the intercostal nerves into the spinal cord.
Eight patients with complete thoracic SCI and delayed presentation more than a year after the injury were analyzed retrospectively. All patients underwent nerve bypass surgery with the transfer of 2 pairs of intercostal nerves from proximal to the injury site to the anterolateral spinal cord, followed by duraplasty with fascia grafting to close the dura.
Six of the 8 (75%) patients demonstrated motor and sensory improvements, based on the American SCI Association score. Three patients demonstrated a limited recovery of motor function that could be independently triggered without ICN initiation. Five patients demonstrated evidence of cerebrospinal fluid leakage after surgery; however, only 1 patient complained of a headache.
Spinal cord bypass surgery is a potential reconstruction method to treat chronic complete thoracic SCI with functional improvements, and is worth further investigation. Spinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve regeneration, reduce complications, and increase quality of life are valuable for these patients. In this study, we aimed to assess nerve bypass surgery's feasibility and clinical outcomes by transferring the intercostal nerves into the spinal cord.OBJECTIVESpinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve regeneration, reduce complications, and increase quality of life are valuable for these patients. In this study, we aimed to assess nerve bypass surgery's feasibility and clinical outcomes by transferring the intercostal nerves into the spinal cord.Eight patients with complete thoracic SCI and delayed presentation more than a year after the injury were analyzed retrospectively. All patients underwent nerve bypass surgery with the transfer of 2 pairs of intercostal nerves from proximal to the injury site to the anterolateral spinal cord, followed by duraplasty with fascia grafting to close the dura.METHODSEight patients with complete thoracic SCI and delayed presentation more than a year after the injury were analyzed retrospectively. All patients underwent nerve bypass surgery with the transfer of 2 pairs of intercostal nerves from proximal to the injury site to the anterolateral spinal cord, followed by duraplasty with fascia grafting to close the dura.Six of the 8 (75%) patients demonstrated motor and sensory improvements, based on the American SCI Association score. Three patients demonstrated a limited recovery of motor function that could be independently triggered without ICN initiation. Five patients demonstrated evidence of cerebrospinal fluid leakage after surgery; however, only 1 patient complained of a headache.RESULTSSix of the 8 (75%) patients demonstrated motor and sensory improvements, based on the American SCI Association score. Three patients demonstrated a limited recovery of motor function that could be independently triggered without ICN initiation. Five patients demonstrated evidence of cerebrospinal fluid leakage after surgery; however, only 1 patient complained of a headache.Spinal cord bypass surgery is a potential reconstruction method to treat chronic complete thoracic SCI with functional improvements, and is worth further investigation.CONCLUSIONSSpinal cord bypass surgery is a potential reconstruction method to treat chronic complete thoracic SCI with functional improvements, and is worth further investigation. |
| Author | Chen, Kuan-Po Li, Yen-Wei Chen, Wen-Liang Tu, Yuan-Kun Hsueh, Yu-Huan |
| Author_xml | – sequence: 1 givenname: Yu-Huan surname: Hsueh fullname: Hsueh, Yu-Huan organization: Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan – sequence: 2 givenname: Yen-Wei surname: Li fullname: Li, Yen-Wei organization: Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan – sequence: 3 givenname: Kuan-Po surname: Chen fullname: Chen, Kuan-Po organization: Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan – sequence: 4 givenname: Wen-Liang surname: Chen fullname: Chen, Wen-Liang organization: College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan – sequence: 5 givenname: Yuan-Kun surname: Tu fullname: Tu, Yuan-Kun email: ed100130@edah.org.tw organization: Department of Orthopedics, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan |
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| Keywords | Reconstruction ASIA Nerve bypass surgery CSF PNG SCI CNS Spinal cord injury ICNs |
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| Snippet | Spinal cord injury (SCI) is a devastating condition that significantly decreases the patient's quality of life. Therefore, treatments that can facilitate nerve... |
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| SubjectTerms | Adult Aged Female Humans Intercostal Nerves - surgery Male Middle Aged Nerve bypass surgery Nerve Transfer - methods Neurosurgical Procedures - methods Plastic Surgery Procedures - methods Reconstruction Recovery of Function Retrospective Studies Spinal Cord - surgery Spinal Cord Injuries - surgery Spinal cord injury Thoracic Vertebrae - surgery Treatment Outcome Young Adult |
| Title | Nerve Bypass Surgery for Spinal Cord Reconstruction |
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