scholarly journals Reconstruction of Sciatic Nerve Using Bilateral Vascularized Sural Nerve Grafts: A Case Report

2021 ◽  
Author(s):  
Si-Gyun Roh ◽  
Jae Young Chun ◽  
Nae-Ho Lee ◽  
Jin Yong Shin ◽  
Jong-Lim Kim
Keyword(s):  
Case Report ◽  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Tumor Resection ◽  
Nerve Graft ◽  
Sensory Function ◽  
Nerve Grafts ◽  
Function Recovery ◽  
Sural Nerve Graft

Injury of peripheral nerve may require reconstruction for motor and sensory function recovery. However, when the nerve defect is long, especially in the lower extremities, reconstruction with successful function recovery proved to be difficult. We documented a case of bilateral vascularized sural nerve graft repair of a large and long sciatic nerve defect following malignant tumor resection on posterior thigh. Although we were unable to achieve satisfactory outcomes in motor function recovery, we did accomplish some sensory function recovery.

scholarly journals First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up

2017 ◽  
Vol 42 (3) ◽  
pp. E2 ◽  
Author(s):  
Zachary C. Gersey ◽  
S. Shelby Burks ◽  
Kim D. Anderson ◽  
Marine Dididze ◽  
Aisha Khan ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Gunshot Wound ◽  
Nerve Repair ◽  
Nerve Graft ◽  
Sensory Function ◽  
Long Term Follow Up

OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were used to supplement human peripheral nerve repair in long-segment injury. Both patients had significant improvement in both motor and sensory function with correlative imaging. This study demonstrates preliminary safety and efficacy of SC transplantation for peripheral nerve repair.

scholarly journals Long-Term Follow-Up after the Sural Nerve Graft on the Injured Temporal Branch of the Facial Nerve: A Case Report

2018 ◽  
Vol 23 (4) ◽  
pp. 306
Author(s):  
Jeong-Hyun Cheon ◽  
Jae-Ho Chung ◽  
Eul-Sik Yoon ◽  
Byung-Il Lee ◽  
Seung-Ha Park
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Sural Nerve ◽  
Nerve Graft ◽  
Long Term Follow Up ◽  
Sural Nerve Graft

scholarly journals Comparison of nerve graft integration after segmentar resection versus epineural burying in crushed rat sciatic nerves

1997 ◽  
Vol 12 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Marco Túlio Rodrigues da Cunha ◽  
Alcino Lázaro da Silva ◽  
Sheila Bernardino Fenelon
Keyword(s):  
Sciatic Nerve ◽  
Sural Nerve ◽  
Wallerian Degeneration ◽  
Nerve Graft ◽  
Nerve Grafts ◽  
Nerve Segment ◽  
Sciatic Nerves ◽  
Group 2 ◽  
Crushed Nerve ◽  
Group 1

The aim of the present paper is to compare and correlate the take of nerve segments in a severely crushed nerve. Forty adult Wistar rats had their right sciatic nerve by a "Péan-Murphy" forceps for 40 minutes. In Group 1 (n=20), a segmentar serection in the crushed sciatic nerve was made. A sural nerve segment from the opposite hindpaw was placed in the gap. In Group 2 (n=20), a lontudinal insision in the epineurium of the lesioned sciatic nerve was made. A sural nerve segment was buried underneath the epineurium. The crushed sciatic nerves undergone Wallerian degeneration and endoneurial fibrosis. Sciatic nerves from Group 2 had significant better histological aspects than those from Group 1. Sural nerve grafts presented better degrees of regeneration than crushed sciatic nerves. Sural nerve grafts from Group 2 (burying method) integrated as well as those from Group 1 (segmentar resection).

Use of Vascularized Sural Nerve Grafts for Sciatic Nerve Reconstruction After Malignant Bone and Soft Tissue Tumor Resection in the Lower Legs

2018 ◽  
Vol 80 (4) ◽  
pp. 379-383 ◽  
Author(s):  
Hideki Tokumoto ◽  
Shinsuke Akita ◽  
Yoshitaka Kubota ◽  
Motone Kuriyama ◽  
Nobuyuki Mitsukawa
Keyword(s):  
Soft Tissue ◽  
Sciatic Nerve ◽  
Sural Nerve ◽  
Soft Tissue Tumor ◽  
Tumor Resection ◽  
Nerve Reconstruction ◽  
Nerve Grafts ◽  
Tissue Tumor

Microneurovascular Reconstruction for Facial Reanimation

2019 ◽  
pp. 393-402
Author(s):  
Michael Klebuc
Keyword(s):  
Sural Nerve ◽  
Motor Nerve ◽  
Muscle Flap ◽  
Nerve Graft ◽  
Muscle Flaps ◽  
Nerve Grafts ◽  
Free Muscle Flap ◽  
Graft Harvest ◽  
Facial Reanimation ◽  
Sural Nerve Graft

Microneurovascular muscle flaps can be effectively employed to reanimate the paralyzed mid-face. This chapter explores the indications and contraindications for free muscle flap smile restoration. Various sources of innervation are examined including the motor nerve to masseter and cross-face nerve grafts, as are different muscle flap donor sites. A detailed description of facial nerve exploration, sural nerve graft harvest, and the cross-face nerve graft procedure are provided. Single and two-staged facial reanimation procedures utilizing free gracilis muscle flaps are also described in detail, including technical nuances, postoperative care, and physical therapy. The technique is well suited for individuals whose native muscles of facial expression have failed to develop in utero, undergone irreversible atrophy, sustained significant trauma, or have been sacrificed during oncologic resection.

Peroneal nerve lesion after sural nerve graft harvest: An unusual complication?case report

Microsurgery ◽  
2005 ◽  
Vol 25 (1) ◽  
pp. 54-56 ◽  
Author(s):  
Heinrich M. Schubert ◽  
Gottfried Wechselberger ◽  
Heribert Hussl ◽  
Thomas Schoeller
Keyword(s):  
Case Report ◽  
Sural Nerve ◽  
Peroneal Nerve ◽  
Nerve Graft ◽  
Unusual Complication ◽  
Nerve Lesion ◽  
Graft Harvest ◽  
Sural Nerve Graft

scholarly journals Partial epineural burying of nerve grafts with different sizes next to or distant from neurorrhaphy’s site: histological and electrophysiological studies in rat sciatic nerves

2001 ◽  
Vol 16 (4) ◽  
pp. 187-194
Author(s):  
Marco Túlio Rodrigues da Cunha ◽  
Alcino Lázaro da Silva ◽  
Maria das Graças Reis ◽  
Valdo José Dias da Silva
Keyword(s):  
Nerve Fiber ◽  
Sural Nerve ◽  
Electrophysiological Study ◽  
Nerve Fibers ◽  
Nerve Graft ◽  
Nerve Grafts ◽  
Group 3 ◽  
Sciatic Nerves ◽  
Sural Nerve Graft ◽  
Group 1

The aim of the present study was to compare and correlate histologically and electromyographically the effects of partial epineural burying of sural nerve segments in sectioned and sutured rat sciatic nerves. Sixty adult male Wistar rats were operated on 3 groups: Group 1, sural nerve graft, 9mm long, placed next to neurorrhaphy; Group 2, sural nerve graft, 9mm long, buryied 10mm distant from neurorrhaphy; Group 3, sural nerve graft, 18mm long, set next to neurorrhaphy. The morphological features were examined at light microscope after 3 months in 45 rats. The elements observed were: vascularization, vacuoles in nerve fibers, mastocytes and inflammatory infiltrate. The morphometry was made after 6 months in 15 rats from Group 1, 2 and 3, measuring external nerve fiber diameters and counting myelinated nerve fibers/mm². The electrophysiological study was perfomed after 6 months, registering maximum amplitude and frequency of EMG pontentials, at rest, in extensor digitorum longus muscle. Group 3 rats presented sciatic nerves better conserved morphologically and mean external nerve fiber diameters greater than those from Groups 1 and 2. There were no significant differences in density of nerve fibers/mm², and in the electrophysiological study in rats from Group 1, 2 and 3. The epineural burying of sural nerve grafts with greater length and placed next to the neurorrhaphy’s site had a significantly better regeneration of the histological features than the smaller ones distant from neurorrhaphy.

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