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Dr. Winfree Harnesses Growth Potential of Nerves After Biopsy

During their growth spurts, teenagers seem to get taller before your eyes. A fast grower might gain an inch every three months.

If you’re someone who needs a haircut every time you turn around, your hair might be growing even faster than a teenager—at a rate of an inch every two months.

But your peripheral nerves leave teenagers and tresses in the dust.

Peripheral nerves are able to grow at the amazing rate of 1 inch per month. And their powers don’t end there: They can even re-attach after being completely severed.

Peripheral nerves connect the brain and spinal cord to muscles and skin throughout the body. There are two basic types of peripheral nerves: “motor” nerves carry movement instructions to the muscles, and “sensory” nerves carry sensory information to the spinal cord and brain.

Neurosurgeon Dr. Christopher Winfree specializes in both types of peripheral nerves. One of Dr. Winfree’s specialties is a procedure called a peripheral nerve biopsy. This procedure can help diagnose people who suffer from rare nerve disorders. Many of these disorders respond well to treatment, once they have been diagnosed correctly.

A nerve biopsy involves removing a piece of nerve. During the procedure, the nerve itself is cut. (When possible, Dr. Winfree selects a sensory nerve whose biopsy will cause a small area of skin numbness, but have no remarkable effect on activities of daily living.) But after nerve biopsies, with a little help from surgeons, peripheral nerves may use their powers of growth to heal themselves again.

Nerve biopsies do not require an overnight hospital stay. Patients receive a local anesthetic to numb the area, as well as a sedative that helps them feel relaxed and drowsy. To perform the biopsy, Dr. Winfree makes an incision in the skin about two centimeters long. He locates the nerve, then cuts it and removes a section.

Though Dr. Winfree removes just a small section during a nerve biopsy, the nerve may have a lot of regrowing to do. Once they are no longer attached, the nerve ends that remain in the body usually retract, or pull farther apart.

To encourage the two ends to heal up again, Dr. Winfree performs a procedure called a conduit repair. The two cut ends of the biopsied nerve are connected with a thin tube called a conduit. The conduit is made of “decellularized” nerve fiber–that is, it does not contain any nerve cells of its own, but its fibers provide structure for the patient’s nerve cells to grow along. Dr. Winfree makes sure that the conduit is long enough to comfortably reach both ends of the nerve.

And then—twice as fast as hair, ten times as fast as fingernails—the nerve begins to regrow. Its fibers are guided toward each other by the conduit. Only a few may reach each other at first, but the nerve can continue to regenerate and improve for up to a year. Half or more of patients will end up recovering useful sensation.

And when you consider that the nerve had been completely severed, its potential to heal itself is amazing.

Learn more about peripheral nerve surgeon Dr. Christopher Winfree on his bio page here.

Image Credit: © 7activestudio/Dollar Photo Club

patient journey

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