Living with nerve damage can significantly impact quality of life, by limiting a person’s capacity to perform everyday tasks and maintain independence.
Nerve repair surgery can aid in restoring lost sensation or movement, providing a long-awaited solution to the source of chronic pain and a compelling avenue for recovery.
Understanding the Function of Nerves
Peripheral nerves act like electrical cables, allowing the brain and spinal cord to communicate with the rest of the body. Motor nerves carry signals from the brain to muscles, allowing the body to move. Sensory nerves send information back to the brain, including sensations of touch, temperature, pressure, and pain. If a nerve is damaged, it can cause paralysis, loss of feeling, or pain in the area of the body supplied by that nerve.
Consistent and Predictable Outcomes in Peripheral Nerve Repair Surgeries
Trauma
Peripheral nerves can be crushed, bruised, stretched, or cut due to traumatic injuries such as motor vehicle or sporting accidents, falls, gunshot wounds, and sharp cuts from glass, knives, or power tools. Due to their small size, nerves may also be unintentionally damaged during surgery. Sometimes nerves may be deliberately cut (e.g., during cancer surgery). The symptoms experienced from nerve injury depend on the location of the nerve injury and severity of the damage, but they range from changes in sensation, muscle weakness and pain, to complete loss of feeling and paralysis.
Neuroma
Nerves outside the spinal cord can regenerate after injury. Sometimes this regeneration goes wrong, and the nerve tissue forms a tangle of nerve fibers called a neuroma. Neuromas can form in the middle of a damaged nerve, or at the end of a severed nerve (e.g., after an amputation), and may cause severe pain and loss of function.
Spinal cord injury
Spinal cord injuries can be devastating, resulting in partial or complete disruption of communication between the brain and the nerves at and below the level of the injury. Without a connection to the brain, peripheral nerves will no longer function. Depending on the severity and location of the spinal cord injury, symptoms can range from reduced feeling and movement to complete loss of sensation and paralysis.
Compression or entrapment
As seen in carpal and cubital tunnel syndromes, nerves can be irritated and compressed from everyday repetitive activities. Chronic irritation and compression can damage the nerve and lead to pain, numbness, and loss of function.
Treatment Options for Nerve Damage
What do I do if I have nerve damage?
If you have suffered a nerve injury, you should see a physician. They will perform a physical examination and may organise tests to determine the type and extent of your injury. Depending on the nature of your injury, they may refer you to a specialist for further assessment and treatment.
What are my treatment options?
Treatment of peripheral nerve damage is dependent on the type and severity of your injury. If the damage to a nerve is bad enough, it may require surgery to heal. Your surgeon will discuss the options that are appropriate for you and your injury.
Nerve reconstruction
If a nerve is completely cut, due to trauma or during surgery (e.g., removal of a neuroma), the two nerve ends need to be re-connected to allow nerve regeneration and to restore function. Where possible, the nerve will be repaired directly by suturing the two ends together. In some cases, if the gap between the two nerve ends is too large, and the surgeon will need to bridge the gap using a nerve graft. Nerve grafts may be autologous (a donor nerve harvested from elsewhere in your body), or an allograft (from donated tissue).
Nerve transfer
Nerve transfer involves taking an uninjured nerve (the donor) and connecting it to the end of a nerve that is no longer functioning (the recipient). If the connection is successful, the nerve fibers regenerate from the donor nerve to the recipient to return function to the area of the body supplied by the recipient nerve.
Nerve transfers are an option when the gap between nerve ends is too large for a graft repair.
Nerve transfer surgery may also be performed to return movement to paralysed limbs in people with spinal cord injuries, or injuries very close to the spinal cord (e.g., brachial plexus injuries). In these procedures, a functioning donor nerve taken from above the level of the injury is connected to a non-functioning nerve below the level of the injury.
Nerve decompression
If a nerve is trapped and compressed by surrounding tissue such as bone, tendon, or ligament, surgery may be required to release the nerve, allowing it to heal. The surgeon may also reposition the nerve to prevent further irritation and compression. Common nerve decompression surgeries include carpal and cubital tunnel release.
Nerve capping
Sometimes it isn’t possible to reconnect a damaged nerve, for example after amputation of a limb or digit. If left untreated, the open nerve end could develop a painful neuroma. One method of reducing the chance of neuroma formation is to place a protective cap around the end of the nerve to protect it from the surrounding tissue.
The Healing Power of Remplir™
Nerve repair surgery can be complex and challenging. The sutures used to repair nerves can themselves have a negative impact on nerve healing. Remplir is a nerve wrap that surgeons can use to assist with nerve repair surgery. Remplir helps in two ways:
- Using Remplir simplifies the surgical procedure by reducing the number of sutures required to keep the nerve ends in place.
- Remplir, when wrapped around the repaired nerve, provides protection of the nerve from the surrounding tissues and provides the ideal environment for healing.
Remplir is the ideal biomaterial for use in nerve repair surgery. It is strong and flexible, making it easy to handle. It doesn’t react or cause inflammation in the body, but creates an optimal healing environment for successful nerve regeneration. Once the nerve has healed, Remplir is broken down by natural processes and is gone within about three months after your surgery.
Meet our Patients
Mobility is foundational to human connection and quality of life. For people who have experienced serious peripheral nerve damage, every recovery milestone matters – as they strive to return to normal function.
Meet Jasmine McGough
The vibrant 14-year-old from Perth was doing what she loved most, riding her mountain bike on a trail with her family in Margaret River, when she hit a log and fell in a particularly harsh position on her back. She fractured her C5 vertebrae and acquired a severe spinal cord injury.
“The treatment I received to repair my nerve damage has been completely life altering. Prior to the treatment I had lost full function of my hand, making the simplest of tasks impossible – from tying my own shoelaces to changing my baby’s nappy. I have now made a full recovery and am now able to complete tasks unassisted and pain-free giving me back my freedom and independence. The treatment has also allowed me to return to the sport I love of rock climbing.”
View Jasmine’s Story →
Meet Liam Shepherd
At the age of 17, Liam was involved in a horrific car accident that left him with a C6 spinal cord injury and confinement to a wheelchair. Since his surgery with Remplir, Liam has reclaimed abilities he once thought impossible – including driving a modified car.
“Now, I refer to myself as basically a paraplegic – that’s how much function I’ve got back. Almost everything that a general person can do, I can do. I can even carry around three or four kilos in one hand without any issues now.”
View Liam’s Story →
Meet Adrian Walsh
There is a moment in time that stands still in the mind of 43-year-old Adrian Walsh. In an instant on 18 June 2017, life for this active father of three changed forever.
“I have just got my drivers license back. I’m now waiting for modifications on my car to get signed off so I can start driving again, which will vastly improve our home life. I drive with my good arm, my left arm, and I accelerate and break with the right arm. Improved arm and finger function makes this so much easier – it’s a big help.”
View Adrian’s Story →Access Remplir™
For more information about how Remplir may help your nerve surgery, please contact us or speak with a qualified healthcare professional.