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Journal of Neurosurgical Sciences 2019 Feb 04

DOI: 10.23736/S0390-5616.19.04572-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Microsurgical repair by autografting in traumatic injuries of peripheral nerves: a series of 50 cases

Renato DONZELLI, Crescenzo CAPONE , Francesco G. SGULÒ, Giuseppe MARINIELLO, Oleksiy DONZELLI, Francesco MAIURI

Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Medicine and Surgery, University “Federico II”, Naples, Italy


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BACKGROUND: Peripheral nerve injuries (PNI) with traumatic origin in upper and lower extremities are pathologies with an important quality-of-life considerations. For neurosurgeons, it is mandatory to understand their physiopathological mechanism and a proper treatment. The authors describe a series of 50 patients with traumatic PNI who underwent microsurgical reconstruction by autologous graft between 1993 and 2014.
METHODS: Patients aged less than 65, who had neurological deficit in a range 3-12 months and severe and persistent nerve injury at electrophysiological examination were included in the study. After grafting, the overall functional recovery of the neurological deficit, the main prognostic factors (age, injured nerve, damage mechanism, gap length and surgical timing) and the postoperative functional outcome were analysed. Neurological and electrophysiological follow-up was at 6-12-24-48 months after surgery.
RESULTS: The results showed that the best neurological recovery can be found in young patients with cut injuries of the upper limbs and that the outcome mainly depends on involved nerve, lesion type and minimum gap length. Moreover, follow-up for these pathologies should last till 48 months.
CONCLUSIONS: In the future, these results could be further improved by the rising new techniques of nerve repair and the advances in neurobiology.


KEY WORDS: Nerve grafts - Peripheral nerve repair - Nerve injury - Nerve reconstruction - Nerve transfer - Peripheral nerve surgery

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