Recent medical techniques for peripheral nerve repair: Clinico-physiological advantages of artificial nerve guidance conduits

Abstract

This review outlines advanced methods for reconstructing injured peripheral nerve fibers, applying a technology of nerve tubulization with nerve guidance conduits (NGCs), and discusses fundamental and applied prospects for further development of clinical and technological studies to solve this medical problem in young and elderly patients. The current neurosurgical practice includes manipulations on nerve fibers, matching and suturing nerve fiber ends (however, it is important to avoid any tension in the zone of diastasis for a successful nerve regeneration), as well as on allo/autologous nerve grafts. Unfortunately, these therapies are not always implementable in some clinical situations due to certain limitations and their association with a potential risk of postoperative complications. Implanting artificial nerve conduits is an alternative reconstructive technique to promote physiological nerve regeneration. The article describes different engineering constructions derived from various materials, which are now either commercially available or undergoing preclinical and clinical studies. The review underlines the necessity of a further scientific search for new materials and polymers, as well as for novel technologies for fabricating artificial nerve conduits suitable for clinical medicine and rehabilitation.