title: Muscle and nerve biopsy for the neurosurgical trainee.
abstract: BACKGROUND
  Nerve and muscle biopsy are common procedures often performed by junior surgical trainees. This educational review article describes the operative details of performing biopsies of muscle and nerve. Indications, pre-operative investigations and complication rates are described to aid in proper patient selection.
  
  
  METHODS
  A systematic literature review was performed to identify the indications, surgical techniques and results for nerve and muscle biopsy.
  
  
  RESULTS
  The most commonly described techniques involve vastus lateralis muscle, distal sural nerve, median sural nerve/gastrocnemius muscle, superficial peroneal nerve/peroneus brevis muscle and superficial radial nerve. Each technique has its own relative merits and intra-operative anatomical nuances. The yield from each of the techniques varies with the indications and patient selection. Complication rates are low but do vary between the techniques.
  
  
  CONCLUSIONS
  Judicious use of pre-operative investigations is required to select out patients whose nerve and muscle biopsy justifies the risk of complications. A thorough knowledge of relevant surgical anatomy and correct specimen handling is paramount to achieving optimal results while avoiding complications.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Department of Neurosurgery, Addenbrooke's Hospital , Cambridge , UK.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hart
authors.forename: Thomas
authors.initials: T
authors.lastname: Santarius
authors.forename: Rikin A
authors.initials: RA
authors.lastname: Trivedi
mesh_terms: D001706:Biopsy / Q000379:methods*; D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency; D018482:Muscle, Skeletal / Q000294:innervation / Q000473:pathology*; D009420:Nervous System / Q000473:pathology*; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000473:pathology; D009493:Neurosurgery / Q000193:education*; D010543:Peroneal Nerve / Q000601:surgery; D013048:Specimen Handling; D013497:Sural Nerve / Q000473:pathology