Abstract
This paper challenges the concept of 'spinal cord autotomy' as an essential process which will prevent the penetration of spinal cord fibres into a peripheral nerve implant. It proposes that mechanical distraction between the graft and the cord is the main reason why spinal cord fibres fail to traverse a graft. Clinical, neurophysiological and histological evidence is presented to show that embedding an autogenous peripheral nerve implant into a trough in the dorsal half of the cord is effective in restoring continuity in some of the long fibre tracts. Reference is made to other recent work which supports these observations. Possible methods of enhancing the number of fibres which traverse the graft are discussed and an attempt is made to anticipate the possible results of the clinical application of this technique in spinal cord injury patients.
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