title: Chronic nerve root entrapment: compression and degeneration.
abstract: Electrode mounts are being developed to improve electrical stimulation and recording. Some are tight-fitting, or even re-shape the nervous structure they interact with, for a more selective, fascicular, access. If these are to be successfully used chronically with human nerve roots, we need to know more about the possible damage caused by the long-term entrapment and possible compression of the roots following electrode implantation. As there are, to date, no such data published, this paper presents a review of the relevant literature on alternative causes of nerve root compression, and a discussion of the degeneration mechanisms observed. A chronic compression below 40 mmHg would not compromise the functionality of the root as far as electrical stimulation and recording applications are concerned. Additionally, any temporary increase in pressure, due for example to post-operative swelling, should be limited to 20 mmHg below the patient's mean arterial pressure, with a maximum of 100 mmHg. Connective tissue growth may cause a slower, but sustained, pressure increase. Therefore, mounts large enough to accommodate the root initially without compressing it, or compliant, elastic, mounts, that may stretch to free a larger cross-sectional area in the weeks after implantation, are recommended.
authors: Implanted Devices Group, Department of Medical Physics and Bioengineering, University College London, WC1E 6BT London, UK. a.vanhoest@ucl.ac.uk
authors: A
authors: A
authors: Vanhoestenberghe
mesh_terms: D000818:Animals; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D004567:Electrodes, Implanted / Q000009:adverse effects; D006801:Humans; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009410:Nerve Degeneration / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011843:Radiculopathy / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013126:Spinal Nerve Roots / Q000473:pathology / Q000502:physiology; D014795:Visual Pathways / Q000473:pathology / Q000502:physiology