Side-to-Side Epineurial Window Nerve Conduit
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Solution Overview
Problem
Current nerve repair methods, such as end-to-end neurorrhaphy and end-to-side neurorrhaphy, are inefficient in reinnervating muscles quickly due to slow axon regeneration, leading to muscle atrophy in cases of significant nerve severance, as they either reconnect proximal and distal segments directly or connect to a donor nerve without allowing for normal reinnervation.
Innovation Solution
The method involves performing side-to-side neurorrhaphy using a bridging element between epineurial windows on a severed nerve and a donor nerve, creating a conduit for signal transmission and axonal growth, thereby inhibiting muscle atrophy by allowing early reinnervation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If end-to-end neurorrhaphy is used to reconnect proximal and distal segments, then the nerve continuity is restored, but the muscle atrophy occurs due to slow axon regeneration (1 mm per day)
Solution Approach 1:
The patent introduces an artificial nerve conduit as an intermediary structure between the proximal and distal nerve segments. This conduit provides a pre-formed pathway that facilitates faster axonal regeneration compared to direct end-to-end connection, thereby reducing the time for muscle reinnervation while maintaining nerve continuity.
Solution Approach 2:
The patent segments the nerve repair process by creating separate epineurial windows in both the proximal and distal segments, with the artificial conduit bridging these windows. This segmentation allows for independent preparation of each nerve segment and provides a structured pathway for axonal regrowth.
2Ease of operation
If end-to-side neurorrhaphy is used to connect to a donor nerve, then the proximal end of distal segment is connected, but normal physiologic reinnervation cannot occur
Solution Approach 1:
The artificial nerve conduit acts as an intermediary that enables the proximal end of the distal segment to connect to the distal end of the proximal segment through a bridged pathway. This maintains the anatomical orientation necessary for normal physiologic reinnervation while providing surgical feasibility even when direct connection is not possible.
3Reliability
If direct reconnection of proximal and distal segments is attempted, then nerve continuity is restored, but the gap between segments prevents effective signal transmission
Solution Approach 1:
The artificial nerve conduit serves as a mediator that spans the gap between proximal and distal nerve segments. It provides a continuous structural pathway that enables signal transmission across the gap without requiring complex surgical maneuvers to bridge the distance directly.
Solution Approach 2:
The patent introduces a spatial dimension by placing the artificial conduit in the gap space between nerve segments. This allows the nerve repair to occur in three-dimensional space, accommodating gaps that would be impossible to bridge with direct linear connection.
Data Source
AI summary
The disclosure provides methods for repairing nerves and inhibiting atrophy of a muscle via a side-to side neurorraphy using a bridging element between a first epineurial window on a donor nerve and a second epineurial window on a recipient nerve.