The Morphology of the Dorsal Part of the First Rib in Neurogenic Thoracic Outlet Syndrome Patients: A Retrospective Clinical Study.

Background: The recurrence or persistence of symptoms after thoracic outlet decompression (TOD) in patients with neurogenic thoracic outlet syndrome (NTOS) is not uncommon. Some authors have shown significantly better clinical outcomes in patients who underwent TOD with exarticulation of the first rib compared to a group who underwent TOD with preservation of the dorsal portion of the first rib. Several other case series have shown significant improvement after redo surgery with removal of the dorsal first rib remnant.

Relevance of Costovertebral Exarticulation of the First Rib in Neurogenic Thoracic Outlet Syndrome: A Retrospective Clinical Study.

Purpose: The failure rate for operative decompression in neurogenic thoracic outlet syndrome (NTOS) is high compared to more distal nerve compression syndromes, such as cubital or carpal tunnel syndrome. Herein, we aimed to determine if a more radical approach, namely costovertebral exarticulation of the first rib, may improve the postoperative results in patients with NTOS. Methods: From October 2002 to December 2020, 105 operative decompressions in 95 patients were evaluated; in 10 cases, decompressions were performed bilaterally.

The role of microstructured and interconnected pore channels in a collagen-based nerve guide on axonal regeneration in peripheral nerves.

The use of bioengineered nerve guides as alternatives for autologous nerve transplantation (ANT) is a promising strategy for the repair of peripheral nerve defects. In the present investigation, we present a collagen-based micro-structured nerve guide (Perimaix) for the repair of 2 cm rat sciatic nerve defects. Perimaix is an open-porous biodegradable nerve guide containing continuous, longitudinally orientated channels for orientated nerve growth.

Evaluation of functional nerve recovery with Visual-SSI--a novel computerized approach for the assessment of the static sciatic index (SSI).

Complete nerve transection (neurotmesis) of the rat sciatic nerve is a well-established animal model. The most frequently used behavioural for evaluation of neurotmesis-induced deficits is the walking track analysis with calculation of the sciatic functional index (SFI). More recently, the static sciatic index (SSI) has been developed, which shows a good correlation with the SFI.

In vitro assessment of axonal growth using dorsal root ganglia explants in a novel three-dimensional collagen matrix.

The goal of this study was the development of a bioartificial nerve guide to induce axonal regeneration in the peripheral nervous system (PNS). In this in vitro study, the ability of a novel, 3-dimensional (3D), highly oriented, cross-linked porcine collagen scaffold to promote directed axonal growth has been studied. Collagen nerve guides with longitudinal guidance channels were manufactured using a series of chemical and mechanical treatments with a patented unidirectional freezing process, followed by freeze-drying (pore sizes 20-50 microm).

Refinements in nerve to muscle neurotization.

A modified surgical technique is introduced, enabling restoration of muscle function with direct muscular neurotization. Reliable clinical outcomes result from this technique. We report on a series of 10 patients in whom the supplying motor nerve had been lost at the level of the neuromuscular junction as the result of trauma or tumor resection.

Sensory reconstruction of the fingertip using the bilaterally innervated sensory cross-finger flap.

The authors present a series of 15 patients with large soft-tissue defects of the fingertips as a prospective, nonrandomized study. In all cases, reconstruction was achieved using a bilaterally innervated sensory cross-finger flap. This sensory fasciocutaneous flap relies on the dorsal branch of the proper digital nerves, which branch off at the level of the head of the proximal phalanx; sensory supply to the dorsal skin of the middle phalanx is thus ensured.