Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Apr;12(4):529-533.
doi: 10.4103/1673-5374.205081.

The reasons for end-to-side coaptation: how does lateral axon sprouting work?

Stefano Geuna  1 , Igor Papalia  2 , Giulia Ronchi  1 , Francesco Stagno d'Alcontres  3 , Konstantinos Natsis  4 , Nikolaos A Papadopulos  5 , Michele R Colonna  3
Affiliations
Review

The reasons for end-to-side coaptation: how does lateral axon sprouting work?

Stefano Geuna et al. Neural Regen Res. 2017 Apr.

Abstract

Nerve fibers are attracted by sutureless end-to-side nerve coaptation into the recipient nerve. Opening a window in the epineurium enhances axon attraction and myelination. The authors analyze the features of nerve repair by end-to-side coaptation. They highlight the known mechanisms of axon sprouting and different hypotheses of start up signals (presence or absence of an epineurial window, role of Schwann cells, signaling from the distal trunk). The clinical literature is also presented and differences between experimental and clinical applications are pointed out. The authors propose their point of view and perspectives deriving from recent experimental and clinical experiences.

Keywords: Schwann cells; end-to-side nerve repair; epineurial window; glues in nerve repair; nerve babysitter procedures; nerve coaptation; nerve graft; nerve regeneration; nerve transfer; peripheral nerve repair; side-to-side nerve repair.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: None declared.

Figures

Figure 1
Figure 1
Representative high resolution light microscopic images of toluidine-blue-stained transverse sections of median nerve 36 weeks after end-to-side coaptation with N-butyl-2-cyanoacrylate. (A) Coaptation with an epineurial window; (B) coaptation without an epineurial window. With an epineurial window, the regenerated fibers are more numerous. Bars: 20 μm.
See this image and copyright information in PMC

References

    1. Akeda K, Hirata H, Matsumoto M, Fukuda A, Tsujii M, Nagakura T, Ogawa S, Yoshida T, Uchida A. Regenerating axons emerge far proximal to the coaptation site in end-to-side nerve coaptation without a perineurial window using a T-shaped chamber. Plast Reconstr Surg. 2006;117:1194–1203. - PubMed
    1. Al-Qattan MM, Al-Thunyan A. Variables affecting axonal regeneration following end-to-side neurorrhaphy. Br J Plast Surg. 1998;51:238–242. - PubMed
    1. Al-Qattan MM. Terminolateral neurorrhaphy: review of experimental and clinical studies. J Reconstr Microsurg. 2001;17:99–108. - PubMed
    1. Amr SM, Moharram AN. Repair of brachial plexus lesions by end-to-side side-to-side grafting neurorrhaphy: experience based on 11 cases. Microsurgery. 2005;25:126–146. - PubMed
    1. Bajrovic F, Kovacic U, Pavcnik M, Sketelj J. Interneuronal signaling is involved in induction of collateral sprouting of nociceptive axons. Neuroscience. 2002;111:587–596. - PubMed