Novel strategies in brachial plexus repair after traumatic avulsion

Abstract

Clinical trials in spinal cord injury (SCI) can be affected by many confounding variables including spontaneous recovery, variation in the lesion type and extend. However, the clinical need and the paucity of effective therapies has spawned a large number of animal studies and clinical trials for SCI. In this review, we suggest that brachial plexus avulsion injury, a longitudinal spinal cord lesion, is a simpler model to test methods of spinal cord repair. We explore reconstructive techniques currently explored for the repair of brachial plexus avulsion and focus on the use of olfactory ensheathing cell transplantation as an adjunct treatment in brachial plexus repair.

Key words:

• Brachial plexus repair
• cell transplantation
• nerve regeneration
• nerve repair
• olfactory-ensheathing cells
• root avulsion
• spinal cord injury

Acknowledgements

This work has been supported by DePuy Spine, British Neurological Research Trust, Spinal Research. This work was undertaken at UCLH/UCL, which also received a portion of funding from the Department of Health's NIHR Biomedical Research Centre's funding scheme.

Authors Contribution

C. Kachramanoglou – conception, design, writing of manuscript and revising, P. Andrews – revised, approved prior to publication, C. East – revised, D. Li - revised, approved prior to publication, G. Raisman – revised, approved prior to publication, T. Carlstedt – revised, involved in design, approved prior to publication, D. Choi – conception, design and revised, final approval for publication.