Fabrication of the Composite Regenerative Peripheral Nerve Interface (C-RPNI) in the Adult Rat

Svientek, Shelby R.; Ursu, Daniel C.; Cederna, Paul S.; Kemp, Stephen W.P.

doi:10.3791/60841-v

Cited by 8 publications

(17 citation statements)

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“…RPNI surgery has demonstrated its reliability and durability in harnessing neural signals for neuroprosthetic control. 35–44 Additionally, RPNI surgery is effective for treatment and prevention of postamputation pain, including both symptomatic neuroma pain and phantom limb pain. 59,64–68 In the authors’ practice, RPNI surgery has also been successful in management of neuromas of superficial sensory nerves particularly in cases of nerve autograft harvest.…”

Section: Discussionmentioning

confidence: 99%

“…RPNI was originally designed as an interface for advanced neural control of prosthetic devices and to overcome the limitations of current control strategies. 33–44 RPNI surgery was developed in response to the limitations of existing peripheral nerve electrodes that directly interface with fascicles but yield well-documented adverse sequelae. 35,45,46 Similarly, the use of surface electromyographic signals to drive a prosthetic limb has been associated with poor prosthetic performance.…”

Section: The Rationale For Rpnimentioning

confidence: 99%

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Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Leach

Dean

Kumar

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Regenerative peripheral nerve interface (RPNI) surgery has been demonstrated to be an effective tool as an interface for neuroprosthetics. Additionally, it has been shown to be a reproducible and reliable strategy for the active treatment and for prevention of neuromas. The purpose of this article is to provide a comprehensive review of RPNI surgery to demonstrate its simplicity and empower reconstructive surgeons to add this to their armamentarium. This article discusses the basic science of neuroma formation and prevention, as well as the theory of RPNI. An anatomic review and discussion of surgical technique for each level of amputation and considerations for other etiologies of traumatic neuromas are included. Lastly, the authors discuss the future of RPNI surgery and compare this with other active techniques for the treatment of neuromas.

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Section: Discussionmentioning

confidence: 99%

Section: The Rationale For Rpnimentioning

confidence: 99%

Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Leach

Dean

Kumar

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…Previously, our group developed the RPNI to create an interface with greater signal specificity and long-term signal stability. 12,28 The muscle graft is reinnervated by the implanted nerve and reliably amplifies independent efferent motor action potentials from the transected motor nerve, which allows upper limb amputees real-time prosthetic finger control. 12,29 Furthermore, RPNIs prevent and treat neuroma pain and phantom limb pain in patients with limb loss.…”

Section: Discussionmentioning

confidence: 99%

“…The DS-RPNI is a modification of our regenerative peripheral nerve interface (RPNI), which consists of a free muscle graft secured around the distal end of transected nerves. 12,28 Here, RPNI muscle grafts are reinnervated by regenerating axons from the transected nerve, and are capable of amplifying independent efferent motor action potentials to allow real-time prosthetic finger control. 11,29 The DS-RPNI consists of small deepithelialized skin grafts secured around fascicles of residual sensory nerves.…”

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confidence: 99%

Dermal Sensory Regenerative Peripheral Nerve Interface (DS-RPNI) for Re-establishing Sensory Nerve Feedback in Peripheral Afferents in the Rat

Sando

Adidharma

Nedic

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Without meaningful, intuitive sensory feedback, even the most advanced myoelectric devices require significant cognitive demand to control. The dermal sensory regenerative peripheral nerve interface (DS-RPNI) is a biological interface designed to establish high-fidelity sensory feedback from prosthetic limbs. Methods: DS-RPNIs were constructed in rats by securing fascicles of residual sensory peripheral nerves into autologous dermal grafts, with the objectives of confirming regeneration of sensory afferents within DS-RPNIs and establishing the reliability of afferent neural response generation with either mechanical or electrical stimulation. Results: Two months after implantation, DS-RPNIs were healthy and displayed well-vascularized dermis with organized axonal collaterals throughout and no evidence of neuroma. Electrophysiologic signals were recorded proximal from DS-RPNI’s sural nerve in response to both mechanical and electrical stimuli and compared with (1) full-thickness skin, (2) deepithelialized skin, and (3) transected sural nerves without DS-RPNI. Mechanical indentation of DS-RPNIs evoked compound sensory nerve action potentials (CSNAPs) that were like those evoked during indentation of full-thickness skin. CSNAP firing rates and waveform amplitudes increased in a graded fashion with increased mechanical indentation. Electrical stimuli delivered to DS-RPNIs reliably elicited CSNAPs at low current thresholds, and CSNAPs gradually increased in amplitude with increasing stimulation current. Conclusions: These findings suggest that afferent nerve fibers successfully reinnervate DS-RPNIs, and that graded stimuli applied to DS-RPNIs produce proximal sensory afferent responses similar to those evoked from normal skin. This confirmation of graded afferent signal transduction through DS-RPNI neural interfaces validate DS-RPNI’s potential role of facilitating sensation in human-machine interfacing. Clinical Relevance Statement: The DS-RPNI is a novel biotic-abiotic neural interface that allows for transduction of sensory stimuli into neural signals. It is expected to advance the restoration of natural sensation and development of sensorimotor control in prosthetics.

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“…In a rat model, sensory interfaces transduced afferent compound sensory nerve action potentials similar to native skin 23. Further investigation is being conducted in integrating combined sensory and motor signals using composite RPNIs that consists of a free muscle graft and a free dermal graft secured around a mixed sensorimotor nerve 24. The implications of a stable and durable interface to integrate sensory and motor signals has immense potential to transform prosthetic rehabilitation for amputation patients.…”

Section: Rpnis and Prosthetic Controlmentioning

confidence: 99%

Regenerative Peripheral Nerve Interfaces for Advanced Prosthetic Control and Mitigation of Postamputation Pain

Kumar

Cederna

Kung

2021

Techniques in Orthopaedics

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While recent advances have occurred in the field of prosthetic technology, there is still a need for a neuroprosthetic interface that permits high-fidelity prosthetic control to accurately replicate extremity movements. Peripheral nerve interfaces offer more intuitive prosthetic control by harnessing neural signals at a fascicular level. The direct application of electrodes to peripheral nerves is limited by device encapsulation, micromotion, and inevitable neural damage. To overcome these challenges, the regenerative peripheral nerve interface (RPNI) has been developed as a promising solution to enhance prosthetic control. During RPNI surgery, the end of a transected peripheral nerve is implanted into an autologous free skeletal muscle graft. The RPNI has demonstrated feasibility in transducing peripheral nerve signals from patients with upper limb amputations to control an artificial hand. In addition, by leveraging the physiological processes of nerve regeneration, muscle regeneration, and reinnervation, RPNIs have been shown to reduce postamputation pain, including neuroma pain and phantom limb pain. It can be used as a treatment for symptomatic neuromas or performed prophylactically at the time of limb amputation to reduce or eliminate postamputation pain. RPNI surgery is a safe, reliable, and reproducible technique that can be easily adopted across a variety of surgical specialties. This article describes the development, validation, and clinical application of the RPNI and discusses the surgical technique.

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Fabrication of the Composite Regenerative Peripheral Nerve Interface (C-RPNI) in the Adult Rat

Cited by 8 publications

References 0 publications

Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Regenerative Peripheral Nerve Interface Surgery: Anatomic and Technical Guide

Dermal Sensory Regenerative Peripheral Nerve Interface (DS-RPNI) for Re-establishing Sensory Nerve Feedback in Peripheral Afferents in the Rat

Regenerative Peripheral Nerve Interfaces for Advanced Prosthetic Control and Mitigation of Postamputation Pain

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