Direct Spinal Ventral Root Repair following Avulsion: Effectiveness of a New Heterologous Fibrin Sealant on Motoneuron Survival and Regeneration
Spinal root avulsion injury causes motoneuron death and immediate loss of sensory and motor functions. Surgical intervention such as reimplantation of avulsed root is proven useful to restore neural circuitry of spinal cord and targeted muscles. Yet, additional strategies are required for faster and better functional recovery which is overall unsatisfactory. Accumulating evidences in animal studies, particularly in peripheral nerve injuries, demonstrated the effectiveness of neurotrophic factors in rescuing injured motoneurons and promoting axon regeneration. It is, however, important to recognize the differences between peripheral nerve and avulsion injury. In this review, we will briefly describe the changes in motoneurons after avulsion and provides a comprehensive list of neurotrophic factors which are known to exert neuroprotective effects on motoneurons. We will include recent studies on trophic factors for motoneuron survival and regeneration in peripheral nerve and avulsion injuries. We will also discuss the potential use of trophic factors in the context of avulsion injuries.