Nerve transfers and neurotization in peripheral nerve injury, from surgery to rehabilitation

J Neurol Neurosurg Psychiatry. 2016 Feb;87(2):188-97. doi: 10.1136/jnnp-2015-310420. Epub 2015 Jul 1.

Abstract

Peripheral nerve injury (PNI) and recent advances in nerve reconstruction (such as neurotization with nerve transfers) have improved outcomes for patients suffering peripheral nerve trauma. The purpose of this paper is to bridge the gap between the electromyographer/clinical neurophysiologist and the peripheral nerve surgeon. Whereas the preceding literature focuses on either the basic science behind nerve injury and reconstruction, or the surgical options and algorithms, this paper demonstrates how electromyography is not just a 'decision tool' when deciding whether to operate but is also essential to all phases of PNI management including surgery and rehabilitation. The recent advances in the reconstruction and rehabilitation of PNI is demonstrated using case examples to assist the electromyographer to understand modern surgical techniques and the unique demands they ask from electrodiagnostic testing.

Keywords: EMG; NEUROANATOMY; NEUROPHYSIOL, CLINICAL; PERIPHERAL NERVE SURGERY; REHABILITATION.

Publication types

  • Review

MeSH terms

  • Humans
  • Nerve Transfer / methods*
  • Neurosurgical Procedures / methods*
  • Peripheral Nerve Injuries / rehabilitation*
  • Peripheral Nerve Injuries / surgery*
  • Peripheral Nerves / surgery