Reply

Abstract

REPLYWe greatly appreciate Dr. Ochoa's comments regarding our study on Cajal bands, and his contributions to the field of peripheral nerve biology. While we are certainly aware of his classic papers. 1 We acknowledge this unfortunate oversight on our part, as we did not cite them in this recent manuscript. 2 As scientists are aware, animal models of disease cannot recapitulate all aspects of a human disease. When we developed our animal models, we chose to have an objective, universally accepted parameter for defining compression neuropathy-a localized, progressive decline of nerve conduction velocity. While our model is based on classic work from Dr. Susan Mackinnon, 3 our previously reported rodent and current murine model uses chemically and mechanically modified tubing so that it does not induce a significant inflammatory response and is loose fitting around the sciatic nerve. 2,4 This is fundamentally different from constriction-based (CCI) models of nerve injury, which mechanically deform the nerve or nerve roots and immediately induce significant inflammation. Our models detail slow segmental demyelination, without inciting early marked inflammation, ischemia, or significant axonal degeneration in the initial crucial weeks after the compression starts. As human tissue from early compression neuropathy is not currently available secondary to the morbidity that would occur from harvesting neural tissue in electrophysiologically confirmed compression neuropathy, these animal models are meant to provide in vivo data and findings so that we can better explore the mechanisms of this condition with in vitro models of compression neuropathy. [5][6][7] We have used this combined in vivo and in vitro modeling of compression neuropathies for the past decade to hopefully develop meaningful nonoperative treatment strategies in the coming years. 1. Ochoa J, Marotte L. Nature of the nerve lesion caused by chronic entrapment in the Guinea-pig. J Neurol Sci 1973;19:491-495. 2. Gupta R, Nassirin N, Bathen M, Hazel A, Palispis W, Mozaffar T. Chronic nerve compression alters Schwann cell myelin architecture in a murine model. Muscle Nerve 2012;45:231-241. 3. O'Brien JP, Mackinnon SE, MacLean AR, Hudson AR, Dellon AL, Hunter DA. A model of chronic nerve compression in the rat. Ann