Epineurial repair

Epineurial Repair
Repair to epineurium via epineurial repair
Anatomical terminology []

Cross Section of Epineurium
Transverse section of human tibial nerve. (Epineurium labeled at upper right.)
Nerve structure
Identifiers
MeSH	A08.800.800
Dorlands /Elsevier	12338150
Anatomical terminology []

Epineurial repair is a common surgical procedure to repair a nerve laceration via the epineurium, the connective tissue surrounding nerve fibers originating from the spinal cord. It is intended to allow the restoration of sensory function. When a nerve is lacerated or cut, repair is done by sewing the cut ends together through the epineurium to increase the potential of the proximal part growing correctly along the route the degrading distal part leaves behind. Usual sensation and mobility will not be an immediate result because nerves grow at a rate of approximately 1 millimeter per day, so it will take a few months to notice the final outcome. Research in use of nerve grafts and nerve growth factors is being done to speed recovery time.

A nerve injury in continuity results when axonal function is nonexistent but the structure of the connective tissue is preserved. More severe nerve injury like axonotmesis or neurotmesis warrant the repair of the epineurium because the connective tissue is damaged. The epineurium is preserved in a nerve injury in continuity by definition and the severity of the injury varies with the amount of the connective tissue preserved. Typical indications for surgery are if the patient who presented with a laceration has no conduction along the axon, signal transmitted across the nerve, or does not recover within a week. Numbness and paralysis varies depending on the amount of functional loss due to the axonal interruption. The lack of signal being sent from the brain across the gap is caused by the laceration. The procedure can be applied to any nerve epineurium. The procedure is used to repair different-sized fascicles and non-grouped fascicles compared to group fascicular and perinuerial repair.

Glial scars can have detrimental effects to neuronal regrowth to aide in the restoration of sensory function. Astrocytes form a barrier preventing further growth by forming gap junctions along with producing molecules that chemically prevent axon extension.