scholarly journals Bladder reinnervation by somatic nerve transfer to pelvic nerve vesical branches does not reinnervate the urethra

2019 ◽  
Vol 39 (1) ◽  
pp. 181-189
Author(s):  
Mary F. Barbe ◽  
Alan S. Braverman ◽  
Danielle M. Salvadeo ◽  
Sandra M. Gomez‐Amaya ◽  
Neil S. Lamarre ◽  
...  
Keyword(s):  
Nerve Transfer ◽  
Pelvic Nerve ◽  
Somatic Nerve

scholarly journals Functional Reinnervation of the Canine Bladder after Spinal Root Transection and Immediate Somatic Nerve Transfer

2008 ◽  
Vol 25 (3) ◽  
pp. 214-224 ◽  
Author(s):  
Michael R. Ruggieri ◽  
Alan S. Braverman ◽  
Linda D'Andrea ◽  
James McCarthy ◽  
Mary F. Barbe
Keyword(s):  
Nerve Transfer ◽  
Spinal Root ◽  
Somatic Nerve

scholarly journals Anatomical feasibility of performing intercostal and ilioinguinal nerve to pelvic nerve transfer: a possible technique to restore lower urinary tract innervation

2012 ◽  
Vol 17 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Justin M. Brown ◽  
Mary F. Barbe ◽  
Michael E. Albo ◽  
H. Henry Lai ◽  
Michael R. Ruggieri
Keyword(s):  
Nerve Transfer ◽  
Pilot Project ◽  
Canine Model ◽  
Anatomical Location ◽  
Detrusor Muscle ◽  
Pelvic Nerve ◽  
Cross Sectional ◽  
Ilioinguinal Nerve ◽  
Nerve Transfers ◽  
Muscle Groups

Object Nerve transfers are effective for restoring control to paralyzed somatic muscle groups and, recently, even to denervated detrusor muscle in a canine model. A pilot project was performed in cadavers to examine the feasibility of transferring somatic nerves to vesical branches of the pelvic nerve as a method for potentially restoring innervation to control the detrusor muscle in humans. Methods Eleven cadavers were dissected bilaterally to expose intercostal, ilioinguinal, and iliohypogastric nerves, along with vesical branches of the pelvic nerve. Ease of access and ability to transfer the former 3 nerves to the pelvic vesical nerves were assessed, as were nerve cross-sectional areas. Results The pelvic vesical nerves were accessed at the base of the bladder, inferior to the ureter and accompanied by inferior vesical vessels. The T-11 and T-12 intercostal nerves were too short for transfer to the pelvic vesical nerves without grafting. Ilioinguinal and iliohypogastric nerves (L-1 origin) were identified retroperitoneally and, with full dissection, were easily transferred to the pelvic vesical nerves intraabdominally. The mean cross-sectional area of the dominant pelvic vesical branch was 2.60 ± 0.169 mm2; ilioinguinal and iliohypogastric branches at the suggested transection site were 2.38 ± 0.32 mm2 (the means are expressed ± SEM). Conclusions Use of the ilioinguinal or iliohypogastric nerves for heterotopic transfer to pelvic vesical nerves is surgically feasible, based on anatomical location and cross-sectional areas.

Reinnervation of the rectum with transfer of the genital branch of the genitofemoral nerve to the pelvic nerve in rats

2018 ◽  
Vol 28 (5) ◽  
pp. 562-567 ◽  
Author(s):  
Chuanjiang Dong ◽  
Ping Zhu ◽  
Zonglan Xie ◽  
Zheqi Fan ◽  
Ziqiang Dong
Keyword(s):  
Nerve Transfer ◽  
Male Rats ◽  
Control Group ◽  
Pelvic Nerve ◽  
Morphological Examination ◽  
Spinal Nerves ◽  
Resection Group ◽  
Genitofemoral Nerve ◽  
The Mean ◽  
Transfer Group

OBJECTIVEThe purpose of this study was to determine the feasibility of rectum reinnervation with transfer of a primarily genitofemoral nerve to the pelvic nerve in the rat.METHODSThirty-six male rats were randomly divided into 3 groups: rats in the nerve transfer group (n = 12) were subjected to rectal denervation and then bilateral genitofemoral nerve–pelvic nerve transfer; rats in the nerve resection group (n = 12) underwent rectum denervation without nerve transfer; and rats in the control group (n = 12) underwent sham surgery. Rectum denervation was achieved by transection of the L-6 spinal nerves, the spinal nerves below L-6, and the pelvic nerve. Four months postoperatively, retrograde nerve tracing, regenerative nerve morphological examination, and rectal manometry assessment were performed.RESULTSRegenerative nerve morphological examination showed good axonal regeneration after genitofemoral nerve transfer. Nerve stimulation induced increased rectal pressures in 10 of 12 rats in the nerve transfer group. The mean rectal pressure in this group was 54.9 ± 7.1 mm Hg, which is higher than the mean value in the nerve resection group (5.5 ± 2.0 mm Hg) but lower than that in the control group (70.6 ± 8.5 mm Hg) (p < 0.05). The appearance of FluoroGold-labeled neurons in the L-1 and L-2 spinal cord segments in the nerve transfer group confirmed the formation of new neural pathways.CONCLUSIONSThe results have demonstrated that genitofemoral nerve–pelvic nerve transfer can achieve nerve regeneration. In this animal model, the authors were able to reinnervate the rectum by nerve transfer.

245: Functional Reinnervation of Canine Bladder by Genitofemoral to Pelvic Nerve Transfer

2007 ◽  
Vol 177 (4S) ◽  
pp. 82-82
Author(s):  
Michael R. Ruggieri ◽  
Alan S. Braverman ◽  
Mary F. Barbe
Keyword(s):  
Nerve Transfer ◽  
Pelvic Nerve

scholarly journals Anatomical feasibility of performing a nerve transfer from the femoral branch to bilateral pelvic nerves in a cadaver: a potential method to restore bladder function following proximal spinal cord injury

2013 ◽  
Vol 18 (6) ◽  
pp. 598-605 ◽  
Author(s):  
Justin M. Brown ◽  
Mary F. Barbe ◽  
Michael E. Albo ◽  
Michael R. Ruggieri
Keyword(s):  
Femoral Nerve ◽  
Nerve Transfer ◽  
Bladder Function ◽  
Anatomical Location ◽  
Detrusor Muscle ◽  
Vastus Medialis ◽  
Pelvic Nerve ◽  
Cross Sectional ◽  
Pelvic Nerves ◽  
Cord Injury

Object Nerve transfers are an effective means of restoring control to paralyzed somatic muscle groups and have recently been shown to be effective in denervated detrusor muscle in a canine model. A cadaveric study was performed to examine the anatomical feasibility of transferring femoral muscular nerve branches to vesical branches of the pelvic nerve as a method of potentially restoring innervation to control the detrusor muscle in humans. Methods Twenty cadavers were dissected bilaterally to expose pelvic and femoral muscular nerve branches. Ease of access and ability to transfer the nerves were assessed, as were nerve cross-sectional areas. Results The pelvic nerve was accessed at the base of the bladder, inferior to the ureter, and accompanied by inferior vesical vessels. Muscular branches of the femoral nerve to the vastus medialis and intermedius muscles (L-3 and L-4 origins) were followed distally for 17.4 ± 0.8 cm. Two muscle branches were split from the femoral nerve trunk, and tunneled inferior to the inguinal ligament. One branch was moved medially toward the base of the bladder and linked to the ipsilateral pelvic nerve. The second branch was tunneled superior to the bladder and linked to the contralateral pelvic nerve. The cross-sectional area of the pelvic nerve vesical branch was 2.60 ± 0.169 mm2 (mean ± SEM), and the femoral nerve branch at the suggested transection site was 4.40 ± 0.41 mm2. Conclusions Use of femoral nerve muscular branches from the vastus medialis and intermedius muscles for heterotopic nerve transfer of bilateral pelvic nerves is surgically feasible, based on anatomical location and cross-sectional areas.

Nerve graft versus nerve transfer for neonatal brachial plexus: shoulder outcomes

2021 ◽  
Vol 27 (1) ◽  
pp. 87-92
Author(s):  
Brandon W. Smith ◽  
Kate W. C. Chang ◽  
Sravanthi Koduri ◽  
Lynda J. S. Yang
Keyword(s):  
Brachial Plexus ◽  
Clinical Data ◽  
External Rotation ◽  
Nerve Transfer ◽  
Shoulder Function ◽  
Nerve Transfers ◽  
Shoulder Flexion ◽  
Significant Difference ◽  
Transfer Strategies ◽  
Shoulder External Rotation

OBJECTIVEThe decision-making in neonatal brachial plexus palsy (NBPP) treatment continues to have many areas in need of clarification. Graft repair was the gold standard until the introduction of nerve transfer strategies. Currently, there is conflicting evidence regarding outcomes in patients with nerve grafts versus nerve transfers in relation to shoulder function. The objective of this study was to further define the outcomes for reconstruction strategies in NBPP with a specific focus on the shoulder.METHODSA cohort of patients with NBPP and surgical repairs from a single center were reviewed. Demographic and standard clinical data, including imaging and electrodiagnostics, were gathered from a clinical database. Clinical data from physical therapy evaluations, including active and passive range of motion, were examined. Statistical analysis was performed on the available data.RESULTSForty-five patients met the inclusion criteria for this study, 19 with graft repair and 26 with nerve transfers. There were no significant differences in demographics between the two groups. Understandably, there were no patients in the nerve grafting group with preganglionic lesions, resulting in a difference in lesion type between the cohorts. There were no differences in preoperative shoulder function between the cohorts. Both groups reached statistically significant improvements in shoulder flexion and shoulder abduction. The nerve transfer group experienced a significant improvement in shoulder external rotation, from −78° to −28° (p = 0.0001), whereas a significant difference was not reached in the graft group. When compared between groups, there appeared to be a trend favoring nerve transfer in shoulder external rotation, with the graft patients improving by 17° and the transfer patients improving by 49° (p = 0.07).CONCLUSIONSIn NBPP, patients with shoulder weakness experience statistically significant improvements in shoulder flexion and abduction after graft repair or nerve transfer, and patients with nerve transfers additionally experience significant improvement in external rotation. With regard to shoulder external rotation, there appear to be some data supporting the use of nerve transfers.

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