ORC ID , Nicholas James1, Mårten Risling2">
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Year : 2017  |  Volume : 12  |  Issue : 12  |  Page : 1960-1963

Surgical reconstruction of spinal cord circuit provides functional return in humans

1 The Wolfson Centre for Age-Related Diseases, King's College London, London, United Kingdom
2 Department of Neuroscience, Karolinska Institutet, Solna, Sweden

Correspondence Address:
Thomas Carlstedt
The Wolfson Centre for Age-Related Diseases, King's College London, London
United Kingdom
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Source of Support: This work was supported by the Wellcome Trust, Karolinska Institutet, Swedish Defence (No. FOT-AF.9221006) and Darwin Trust of Edinburgh, Conflict of Interest: None

DOI: 10.4103/1673-5374.221145

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This mini review describes the current surgical strategy for restoring function after traumatic spinal nerve root avulsion in brachial or lumbosacral plexus injury in man. As this lesion is a spinal cord or central nervous injury functional return depends on spinal cord nerve cell growth within the central nervous system. Basic science, clinical research and human application has demonstrated good and useful motor function after ventral root avulsion followed by spinal cord reimplantation. Recently, sensory return could be demonstrated following spinal cord surgery bypassing the injured primary sensory neuron. Experimental data showed that most of the recovery depended on new growth reinnervating peripheral receptors. Restored sensory function and the return of spinal reflex was demonstrated by electrophysiology and functional magnetic resonance imaging of human cortex. This spinal cord surgery is a unique treatment of central nervous system injury resulting in useful functional return. Further improvements will not depend on surgical improvements. Adjuvant therapy aiming at ameliorating the activity in retinoic acid elements in dorsal root ganglion neurons could be a new therapeutic avenue in restoring spinal cord circuits after nerve root avulsion injury.

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