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Repair and rehabilitation of plexus and root avulsions in animal models and patients

Havton, Leif Aa; Carlstedt, Thomasb,c

doi: 10.1097/WCO.0b013e328331b63f
Trauma and rehabilitation: Edited by Bruce Dobkin

Purpose of review This review will discuss recent progress in experimental and translational research related to surgical repair of proximal nerve root injuries, and emerging potential therapies, which may be combined with replantation surgeries to augment functional outcomes after brachial plexus and cauda equina injuries.

Recent findings Progress in experimental studies of root and peripheral nerve injuries has identified potential candidates for adjunctive therapies, which may be combined with surgical replantation of avulsed roots after brachial plexus and cauda equina injuries. We will discuss recent advances related to adjunctive neuroprotective strategies, neurotrophic factor delivery, and emerging cellular treatment strategies after extensive nerve root trauma. We will also provide an update on electrical stimulation to promote regenerative axonal growth and new insights on the recovery of sensory functions after root injury and repair.

Summary In the light of recent advances in experimental studies, we envision that future repair of brachial plexus and cauda equina injuries will include spinal cord surgery to restore motor and sensory trajectories and a variety of adjunctive therapies to augment the recovery of neurological function.

aDepartment of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA

bKarolinska Institute, Stockholm, Sweden

cUniversity College London, London, UK

Correspondence to Leif A. Havton, MD, PhD, Department of Neurology, David Geffen School of Medicine at UCLA, 635 Charles E. Young Drive South, Los Angeles, CA 90095, USA Tel: +1 310 206 5757; fax: +1 310 206 5533; e-mail: lhavton@mednet.ucla.edu

© 2009 Lippincott Williams & Wilkins, Inc.