Chapter

Treatment Strategies

Thomas M. Brushart

in Nerve Repair

Published on behalf of Oxford University Press

Published in print May 2011 | ISBN: 9780195169904
Published online September 2012 | e-ISBN: 9780199965168 | DOI: http://dx.doi.org/10.1093/med/9780195169904.003.0012
Treatment Strategies

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  • Sensory and Motor Systems
  • Rehabilitation Medicine

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Nerve regeneration depends upon multiple coordinated events for its success, each of which could be manipulated to enhance functional restoration. To maximize clinical improvement after peripheral nerve injury, a treatment strategy must accomplish the following: 1) Enhance and maintain the neuronal growth state to promote axons across the inhibitory milieu of the repair site and speed regeneration 2) Increase regeneration specificity by guiding axons to functionally appropriate Schwann cell tubes in the distal stump, 3) Maintain the ability of chronically denervated Schwann cells to support regeneration, 4) Sustain the viability of denervated end organs, and 5) Maximize the CNS compensation for peripheral miswiring. Other goals, such as preventing the death of axotomized neurons, may be important in some settings but not in others. The consequences of failure in each of these categories have been described in earlier chapters. Chapter 12 presents many of the solutions that have been devised for these challenges. Its organization mirrors that of Chapter 9, focusing on specific anatomical areas and the events that occur there rather than on treatment modalities per se.

Chapter.  24230 words.  Illustrated.

Subjects: Sensory and Motor Systems ; Rehabilitation Medicine

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