Chapter 185 - Nerve Transfers: Indications and Techniques

Abstract

Nerve transfer (neurotization) is a well-known technique to peripheral nerve surgeons. A functioning but expendable nerve, branch, or fascicle is transferred to a nonfunctioning but more important nerve. Nerve transfers have long been used to treat preganglionic injury when nerve grafting is not an option. More recently, in view of improved outcomes, they are being employed in cases of postganglionic injury, preferentially over nerve grafting techniques. Nerve transfers are being used in cases of deficit from other nontraumatic causes as well (e.g., tumor, inflammation, etc). They are also being used in distal injuries affecting the peripheral nerve. Recently, nerve transfers have been used in cases of central nervous system injury (such as spinal cord injury or spasticity).