Microscale surgery on single axons.

OBJECTIVE The lack of meaningful axon regeneration after central nervous system damage and poor functional recovery after serious peripheral nervous system nerve injuries have been long-standing problems of substantial interest to both neurosurgeons and neurobiologists. As an alternative to strategies that seek to promote the regeneration of adult axons, our research group has taken advantage of advances in microtechnology to develop a paradigm of direct axon repair involving the substitution of damaged axon regions with healthy segments from donor axons. METHODS This repair methodology uses a novel combination of microtechnology, electrokinetic axon manipulation, and the well-established biological principle of cell fusion. These three fields of research have been integrated in a multidisciplinary approach to develop a solution for a significant clinical problem that currently has no specific treatment. RESULTS The findings reported here provide some initial proof of principle for the core technologies we intend to use for axon repair. Functional recovery from nerve damage of course is clinically challenging, and many obstacles would need to be overcome before such axon repair procedures can be contemplated for therapeutic use. We identify some of the clinical issues that must be addressed for microtechnology-assisted axon repair to transition from the realm of research into actual surgical settings. CONCLUSION It is hoped that each advance in axon repair technology will spur additional research to provide us with a comprehensive understanding on how best to pursue neurosurgical intervention at the microscale.