Structural Injury to the Human Sciatic Nerve After Intraneural Needle Insertion

Abstract

Our findings suggest that intraneural needle insertion may more commonly result in interfascicular rather than intrafascicular needle placement.

Direct electrical stimulation on the injured ulnar nerve using acupuncture needles combined with rehabilitation accelerates nerve regeneration and functional recovery—A case report

“…20 Another study stated that intraneural needle insertion may result in 13 interfascicular rather than intrafascicular needle placement due to the difference in consistency between the densely packed, poorly compliant fascicles protected by the perineurium, based on the experiment of the sciatic nerve dissected from a cryopreserved cadaver. 21 The current used for electroacupuncture ranges from 0.5 to 20 mA, and around 50 mA may be harmful to heart function or implanted medical devices. 8 Regarding the frequency of ES, a study indicated that lower frequency, particularly at 2 Hz, led to more nerve regeneration.…”

Incidence of unintentional intraneural injection and postoperative neurological complications with ultrasound‐guided interscalene and supraclavicular nerve blocks*

“…For example, in cryopreserved human sciatic nerves, blunt-and sharp-tipped needles were each inserted five times. Microscopic examination of 520 stained fascicles demonstrated that no fascicles were damaged by the blunt needles and only 3.2% were damaged by the sharp needles [23]. Other investigators using an animal model, have, however, reported that should a fascicle become impaled, the use of a blunt needle resulted in more frequent and severe nerve injury than a sharp tipped needle [24].…”

From basic concepts to emerging technologies in regional anesthesia

“…This study suggests that the path of least resistance for an intraneurally placed needle may be through the more compliant adipose tissue of the interfascicular epineurium rather than through the fascicles. The ratio of fasicular to epineurial tissue varies between 30 and 70% of the total nerve area [5]. This relationship deviates not only between different nerves but also within individual nerves.…”

“…The risk and extent of nerve injury after intentional intraneural needle placement was investigated by SalaBlanch et al [5] in a cryopreserved cadaveric sciatic nerve. Impalement of the sciatic nerve resulted in structural damage to only 3.2% of fascicles in the immediate vicinity of the needle trajectory.…”