New Aspects in Nerve Regeneration

Peripheral nerve injuries represent a major cause of morbidity and disability worldwide. In addition to the economic burden on the national level, peripheral nerve injuries impose substantial costs on society in terms of long-term disability, reduced quality of life, and pain. It has been estimated that peripheral nerve injuries affect 2.8% of all trauma patients, many of whom acquire life-long disability. The annual incidence of peripheral nerve injuries in developed countries has been reported as 13 to 23 out of 100,000 persons. Recovery following severe peripheral nerve injury is often dismal, despite the inherent capability for axonal regeneration. Autologous nerve grafts are considered the gold standard treatment in cases of nerve defect, although often not providing satisfactory results. Moreover, autologous nerve donor may cause related neurological morbidity at the donor site, including possible neuroma formation. The use of nerve guidance channels (tubes), sutured in between the proximal and distal nerve stumps, has been actively pursued to obviate the need for the second procedure at the donor site and to obtain better regenerative results in comparison to the autologous nerve graft.