Pathophysiology of nerve compression syndromes: Response of peripheral nerves to loading

Journal of Bone and Joint Surgery

Volumn 81, Issue 11, 1999, Pages 1600-1610

  Rempel, David ^a   Dahlin, Lars ^b   Lundborg, Göran ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b LUND UNIVERSITY HOSPITAL   (Sweden)

Author keywords

[No Author keywords available]

Indexed keywords

HISTOPATHOLOGY; HUMAN; NERVE COMPRESSION; NEUROANATOMY; NEUROPATHOLOGY; PATHOPHYSIOLOGY; PRIORITY JOURNAL; REVIEW;

EID: 0032729344     PISSN: 00219355     EISSN: None     Source Type: Journal    
DOI: 10.2106/00004623-199911000-00013     Document Type: Review

References (93)

1. Armstrong, T. J.; Castelli, W. A.; Evans, F. G.; and Diaz-Perez, R.: Some histological changes in carpal tunnel contents and their biomechanical implications. J. Occup. Med., 26: 197-201, 1984.
2. Benstead, T. J.; Sangalang, V. E.; and Dyck, P. J.: Acute endothelial swelling is induced in endoneurial microvessels by ischemia. J. Neural. Sci., 99: 37-49, 1990.
3. Bergman, S.; Widerberg, A.; Danielsen, N.; Lundborg, G.; and Dahlin, L. B.: Nerve regeneration in nerve grafts conditioned by vibration exposure. Restorative Neurol, and Neurosci., 7: 165-169, 1995.
4. Chang, K. Y.; Ho., S. T.; and Yu, H. S.: Vibration induced neurophysiological and electron microscopical changes in rat peripheral nerves. Occup. and Environ. Med., 51: 130-135, 1994.
5. Clark, W. L.; Trumble, T. E.; Swiontkowski, M. E.; and Tencer, A. F.: Nerve tension and blood flow in a rat model of immediate and delayed repairs. J. HandSurg., 17A: 677-687, 1992.
6. Cobb, T. K.; Cooney, W. P.; and An, K. N.: Aetiology of work-related carpal tunnel syndrome: the role of lumbricle muscles and tool size on carpal tunnel pressures. Ergonomics, 39:103-107, 1996.
7. Cornefjord, M.; Sato, K.; Olmarker, K.; Rydevik, B.; and Nordborg, C.: A model for chronic nerve root compression studies. Presentation of a porcine model for controlled, slow-onset compression with analyses of anatomic aspects, compression onset rate, and morphologic and neurophysiologic effects. Spine, 22: 946-957, 1997.
8. Dahlin, L. B., and McLean, W. G.: Effects of graded experimental compression on slow and fast axonal transport in rabbit vagus nerve. J. Neurol. Sci., 72: 19-30, 1986.
9. Dahlin, L. B.; Meiri, K. F.; McLean, W. G.; Rydevik, B.; and Sjostrand, J.: Effects of nerve compression on fast axonal transport in streptozotocin-induced diabetes mellitus. An experimental study in the sciatic nerve of rats. Diabetologia, 29: 181-185, 1986.
10. Dahlin, L. B., and Lundborg, G.: The neurone and its response to peripheral nerve compression. J. Hand Surg., 15-B: 5-10, 1990.
11. Dahlin, L. B., and Kanje, M.: Conditioning effect induced by chronic nerve compression. An experimental study of the sciatic and tibial nerves of rats. Scandinavian J. Plast, and Reconstr. Surg. and Hand Surg., 26: 37-41, 1992.
12. Dahlin, L. B.; Necking, L. E.; Lundstrom, R.; and Lundborg, G.: Vibration exposure and conditioning lesion effect in nerves: an experimental study in rats. J. Hand Surg., 17A: 858-861, 1992.
13. Dahlin, L. B.; Archer, D. R.; and McLean, W. G.: Axonal transport and morphological changes following nerve compression. An experimental study in the rabbit vagus nerve. J. Hand Surg., 18-B: 106-110, 1993.
14. Dahlin, L. B., and Thambert, C.: Acute nerve compression at low pressures has a conditioning lesion effect on rat sciatic nerve. Acta Orthop. Scandinavica, 64: 479-481, 1993.
15. Denny-Brown, D., and Brenner, C.: Lesion in peripheral nerve resulting from compression by spring clip. Arch. Neurol, and Psychiat., 52: 1-19, 1944.
16. Dyck, P. J.; Lais, A. C.; Giannini, C.; and Engelstad, J. K.: Structural alterations of nerve during cuff compression. Proc. Nat. Acad. Sci., 87: 9828-9832, 1990.
17. Emara, M., and Saadah, A. M.: The carpal tunnel syndrome in hypertensive patients treated with beta-blockers. Postgrad. Med. J., 64: 191-192, 1988.
18. Faithfull, D. K.; Moir, D. H.; and Ireland, J.: The micropathology of the typical carpal tunnel syndrome. J. Hand Surg., 11-B: 131-132, 1986.
19. Fowler, T. J.; Danta, G.; and Gilliatt, R. W.: Recovery of nerve conduction after a pneumatic tourniquet: observations on the hind-limb of the baboon. J. Neurol, Neurosurg., and Psychiat., 35: 638-647, 1972.
20. Fuchs, P. C.; Nathan, P. A.; and Myers, L. D.: Synovial histology and carpal tunnel syndrome. J. Hand Surg., 16A: 753-758, 1991.
21. Gelberman, R. H.; Hergenroeder, P. T.; Hargens, A. R.; Lundborg, G. N.; and Akeson, W. H.: The carpal tunnel syndrome. A study of carpal canal pressures. J. Bone and Joint Surg., 63-A: 380-383, March 1981.
22. Gelberman, R. H.; Szabo, R. M.; Williamson, R. V.; and Dimick, M. P.: Sensibility testing in peripheral-nerve compression syndromes. An experimental study in humans. J. Bone and Joint Surg., 65-A: 632-638. June 1983.
23. Gelberman, R. H.; Yamaguchi, K.; Hollstien, S. B.; Winn, S. S.; Heidenreich, E P., Jr.; Bindra, R. R.; Hsieh, P.; and Silva, M. J.: Changes in interstitial pressure and cross-sectional area of the cubital tunnel and of the ulnar nerve with flexion of the elbow. An experimental study in human cadavera. J. Bone and Joint Surg., 80-A: 492-501, April 1998.
24. Grafstein, B., and Forman, D. S.: Intracellular transport in neurons. Physiol. Rev., 60: 1167-1283, 1980.
25. Hamanaka, I.; Okutsu, I.; Shimizu, K.; Takatori, Y.; and Ninomiya, S.: Evaluation of carpal canal pressure in carpal tunnel syndrome. J. Hand Surg., 20A: 848-854, 1995.
26. Ho, S. T., and Yu, H. S.: Ultrastructural changes of the peripheral nerve induced by vibration: an experimental study. British J. Indust. Med., 46: 157-164, 1989.
27. Horiuchi, Y.: Experimental study on peripheral nerve lesions -compression neuropathy. J. Japanese Orthop. Assn., 57: 789-803, 1983.
28. Kajander, K. C.; Pollock, C. H.; and Berg, H.: Evaluation of hindpaw position in rats during chronic constriction injury (CCI) produced with different suture materials. Somatosensory and Motor Res., 13: 95-101, 1996.
29. Kanje, M.; Stenberg, L.; Ahlin, A.; and Dahlin, L. B.: Activation of non-neuronal cells in the rat sciatic nerve in response to inflammation caused by implanted silicone tubes. Restorative Neurol. and Neurosci., 8: 181-187, 1995.
30. Keir, P. J.; Bach, J. M.; and Rempel, D. M.: Effects of finger posture on carpal tunnel pressure during wrist motion. J. Hand Surg., 23A: 1004-1009, 1998.
31. Keir, P. J.; Bach, J. M.; and Rempel, D. M.: Fingertip loading and carpal tunnel pressure: differences between a pinching and a pressing task. J. Orthop. Res., 16: 112-115, 1998.
32. Kerr, C. D.; Sybert, D. R.; and Albarracin, N. S.: An analysis of the flexor synovium in idiopathic carpal tunnel syndrome: a report of 625 cases. J. Hand Surg., 17A: 1028-1030, 1992.
33. Knox, C. A.; Kokmen, E.; and Dyck, P. J.: Morphometric alteration of rat myelinated fibers with aging. J. Neuropathol. and Exper. Neurol, 48: 119-139, 1989.
34. Kumar, K.; Deshpande, S.; Jain, M.; and Nayak, M. G.: Evaluation of various fibro-osseous tunnel pressures (carpal, cubital and tarsal) in normal human subjects. Indian J. Physiol. and Pharmacol., 32: 139-145, 1988.
35. Luchetti, R.; Schoenhuber, R.; De Cicco, G.; Alfarano, M.; Deluca, S.; and Landi, A.: Carpal-tunnel pressure. Acta Orthop. Scandinavica, 60: 397-399, 1989.
36. Lundborg, G.: Ischemic nerve injury. Experimental studies on intraneural microvascular pathophysiology and nerve function in a limb subjected to temporary circulatory arrest. Scandinavian J. Plast, and Reconstr. Surg., Supplementum 6: 3-113, 1970.
37. Lundborg, G., and Rydevik, B.: Effects of stretching the tibial nerve of the rabbit. A preliminary study of the intraneural circulation and the barrier function of the perineurium. J. Bone and Joint Surg., 55-B(2): 390-401, 1973.
38. Lundborg, G.: Structure and function of the intraneural microvessels as related to trauma, edema formation, and nerve function. J. Bone and Joint Surg., 57-A: 938-948, Oct. 1975.
39. Lundborg, G.; Gelberman, R. H.; Minteer-Convery, M.; Lee, Y. F.; and Hargens, A. R.: Median nerve compression in the carpal tunnel - functional response to experimentally induced controlled pressure. J. Hand Surg., 7: 252-259, 1982.
40. Lundborg, G.; Myers, R.; and Powell, H.: Nerve compression injury and increased endoneurial fluid pressure: a "miniature compartment syndrome." J. Neurol., Neurosurg., and Psychiat., 46: 1119-1124, 1983.
41. Lundborg, G.; Dahlin, L. B.; Danielsen, N.; Hansson, H. A.; Necking, L. E.; and Pyykko, I.: Intraneural edema following exposure to vibration. Scandinavian J. Work Environ. and Health, 13: 326-329, 1987.
42. Lundborg, G.; Dahlin, L. B.; Hansson, H.-A.; Kanje, M.; and Necking, L.-E.: Vibration exposure and peripheral nerve fiber damage. J. Hand Surg., 15A: 346-351, 1990.
43. Lundborg, G., and Dahlin, L. B.: Anatomy, function, and pathophysiology of peripheral nerves and nerve compression. Hand Clin., 12: 185-193, 1996.
44. Mackinnon, S. E.; Dellon, A. L.; Hudson, A. R.; and Hunter, D. A.: A primate model for chronic nerve compression. J. Reconstr. Microsurg., 1: 185-195, 1985.
45. Mackinnon, S. E.; Dellon, A. L.; Hudson, A. R.; and Hunter, D. A.: Chronic human nerve compression - a histologic assessment. Neuropathol. and Appl. Neurobiol., 12: 547-565, 1986.
46. Macnichol, M. F.: Extraneural pressures affecting the ulnar nerve at the elbow. Hand, 14: 5-11, 1982.
47. Mackinnon, S. E.; Dellon, A. L.; Hudson, A. R.; and Hunter, D. A.: Chronic nerve compression - an experimental model in the rat. Ann. Plast. Surg., 13: 112-120, 1984.
48. Millesi, H.; Zöch, G.; and Rath, T.: The gliding apparatus of peripheral nerve and its clinical significance. Ann. Hand Surg., 9: 87-97, 1990.
49. Mosconi, T., and Kruger, L.: Fixed-diameter polyethylene cuffs applied to the rat sciatic nerve induce a painful neuropathy: ultrastructural morphometric analysis of axonal alterations. Pain, 64: 37-57, 1996.
50. Myers, R. R.; Powell, H. C.; Costello, M. L.; Lampert, P. W.; and Zweifach, B. W.: Endoneurial fluid pressure: direct measurement with micropipettes. Brain Res., 148: 510-515, 1978.
51. Myers, R. R.; Mizisin, A. P.; Powell, H. C.; and Lampert, P. W.: Reduced nerve blood flow in hexacholorophene neuropathy: relationship to elevated endoneurial fluid pressure. J. Neuropathol. and Exper. Neurol., 41: 391-399, 1982.
52. Nakamichi, K., and Tachibana, S.: Restricted motion of the median nerve in carpal tunnel syndrome. J. Hand Surg., 20-B: 460-464, 1995.
53. Neal, N. C.; McManners, J.; and Stirling, G. A.: Pathology of the flexor tendon sheath in the spontaneous carpal tunnel syndrome. J. Hand Surg., 12-B: 229-232, 1987.
54. Neary, D., and Eames, R. A.: The pathology of ulnar nerve compression in man. Neuropathol. and Appl. Neurobiol., 1: 69-88, 1975.
55. Neary, D.; Ochoa, J.; and Gilliatt, R. W.: Sub-clinical entrapment neuropathy in man. J. Neurol. Sci., 24: 283-298, 1975.
56. Nemoto, K.: An experimental study on the vulnerability of the peripheral nerve. J. Japanese Orthop. Assn., 57: 1773-1786, 1983.
57. Ochoa, J.; Fowler, T. J.; and Gilliatt, R. W.: Anatomical changes in peripheral nerves compressed by a pneumatic tourniquet. J. Anat., 113: 433-455, 1972.
58. Ochoa, J., and Marotte, L.: The nature of the nerve lesion caused by chronic entrapment in guinea-pig. J. Neurol. Sci., 19: 491-495, 1973.
59. Ogata, K., and Naito, M.: Blood flow of peripheral nerve effects of dissection, stretching and compression. J. Hand Surg., 11-B: 10-14, 1986.
60. Okutsu, I.; Ninomiya, S.; Hamanaka, I.; Kuroshima, N.; and Inanami, H.: Measurement of pressure in the carpal canal before and after endoscopie management of carpal tunnel syndrome. J. Bone and Joint Surg., 71-A: 679-683, June 1989.
61. Phalen, G. S.: The carpal-tunnel syndrome. Clinical evaluation of 598 hands. Clin. Orthop., 83: 29-40, 1972.
62. Powell, H. C., and Myers, R. R.: Pathology of experimental nerve compression. Lab. Invest., 55: 91-100, 1986.
63. Rempel, D.; Manojlovic, R.; Levinsohn, D. G.; Bloom, T.; and Gordon, L.: The effect of wearing a flexible wrist splint on carpal tunnel pressure during repetitive hand activity. J. Hand Surg., 19A: 106-110, 1994.
64. Rempel, D.; Keir, P. J.; Smutz, W. P.; and Hargens, A.: Effects of static fingertip loading on carpal tunnel pressure. J. Orthop. Res., 15: 422-426, 1997.
65. Rempel, D.; Bach, J. M.; Gordon, L.; and So, Y.: Eflects of forearm pronation/supination on carpal tunnel pressure. J. Hand Surg., 23A: 38-42, 1998.
66. Rojviroj, S.; Sirichativapee, W.; Kowsuwon, W.; Wongwiwattananon, J.; Tamnanthong, N.; and Jeeravipoolvarn, P.: Pressures in the carpal tunnel. A comparison between patients with carpal tunnel syndrome and normal subjects. J. Bone and Joint Surg., 72-B(3): 516-518, 1990.
67. Rydevik, B., and Lundborg, G.: Permeability of intraneural microvessels and perineurium following acute, graded experimental nerve compression. Scandinavian J. Plast. and Reconstr. Surg., 11: 179-187, 1977.
68. Rydevik, B.; Lundborg, G.; and Bagge, U.: Effects of graded compression on intraneural blood flow. An in vivo study on rabbit tibial nerve. J. Hand Surg., 6: 3-12, 1981.
69. Scelsi, R.; Zanlungo, M.; and Tenti, P.: Carpal tunnel syndrome. Anatomical and clinical correlations and morphological and ultrastructural aspects of the tenosynovial sheath. Italian J. Orthop. and Traumat., 15: 75-80, 1989.
70. Schuind, F.; Ventura, M.; and Pasteels, J. L.: Idiopathic carpal tunnel syndrome: histologic study of flexor tendon synovium. J. Hand Surg., 15A: 497-503, 1990.
71. Seradge, H.; Jia, Y. C.; and Owens, W.: In vivo measurement of carpal tunnel pressure in the functioning hand. J. Hand Surg., 20A: 855-859, 1995.
72. Smith, E. M.; Sonstegard, D. A.; and Andersen, W. H., Jr.: Carpal tunnel syndrome: contribution of flexor tendons. Arch. Phys. Med. and Rehab., 58: 379-385,1977.
73. Sommers C.; Galbraith, J. A.; Heckman, H. M.; and Myers, R. R.: Pathology of experimental compression neuropathy producing hyperesthesia. J. Neuropathol. and Exper. Neurol., 52: 223-233, 1993.
74. Stromberg, T.; Lundborg, G.; Holmquist, B.; and Dahlin, L. B.: Impaired regeneration in rat sciatic nerves exposed to short-term vibration. J. Hand Surg., 21-B: 746-749, 1996.
75. Stromberg, T.; Dahlin, L. B.; Brun, A.; and Lundborg, G.: Structural nerve changes at wrist level in workers exposed to vibration. Occup. and Environ. Med., 54: 307-311, 1997.
76. Sunderland, S.: Nerves and Nerve Injuries, pp. 1-13. Edinburgh, Churchill Livingstone, 1978.
77. Szabo, R. M.; Gelberman, R. H.; Williamson, R. V.; and Hargens, A. R.: Effects of increased systemic blood pressure on the tissue fluid pressure threshold of peripheral nerve. J. Orthop. Res., 1: 172-178, 1983.
78. Szabo, R. M., and Chidgey, L. K.: Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients. J. Hand Surg., 14A: 624-627, 1989.
79. Szabo, R. M., and Sharkey, N. A.: Response of peripheral nerve to cyclic compression in a laboratory rat model. J. Orthop. Res., 11: 828-833, 1993.
80. Takeuchi, T.; Futatsuka, M.; Imanishi, H.; and Yamada, S.: Pathological changes observed in the finger biopsy of patients with vibration-induced white finger. Scandinavian J. Work Environ. and Health, 12: 280-283, 1986.
81. Takeuchi, T.; Takeya, M.; and Imanishi, H.: Ultrastructural changes in peripheral nerves of the fingers of three vibration-exposed persons with Raynaud's phenomenon. Scandinavian J. Work Environ, and Health, 14: 31-35, 1988.
82. Thomas, P. K.: The connective tissue of peripheral nerve: an electron microscope study. J. Anat., 97:35-44, 1963.
83. Toby, E. B., and Hanesworth, D.: Ulnar nerve strains at the elbow. J. Hand Surg., 23A: 992-997, 1998.
84. Toh, E., and Mochida, J.: Histologic analysis of the lumbosacral nerve roots after compression in young and aged rabbits. Spine, 22: 721-726, 1997.
85. Weisl, H., and Osborne, G. V.: The pathological changes in rats' nerves subject to moderate compression. J. Bone and Joint Surg., 46-B(2): 297-306, 1964.
86. Weiss, N. D.; Gordon, L.; Bloom, T.; So, Y.; and Rempel, D. M.: Position of the wrist associated with the lowest carpal-tunnel pressure: implications for splint design. J. Bone and Joint Surg., 77-A: 1695-1699. Nov. 1995.
87. Weiss, P., and Davis, H.: Pressure block in nerves provided with arterial sleeves. J. Neurophysiol., 6: 269-286, 1943.
88. Werner, C. O.; Elniqvist, D.; and Ohlin, P.: Pressure and nerve lesion in the carpal tunnel. Acta Orthop. Scandinavica, 54: 312-316, 1983.
89. Werner, R.; Armstrong, T. J.; Bir, C.; and Aylard, M. K.: Intracarpal canal pressures: the role of finger, hand, wrist and forearm position. Clin. Biomech., 12: 44-51, 1997.
90. Wilgis, E. F. S., and Murphy, R.: The significance of longitudinal excursion in peripheral nerves. Hand Clin., 2: 761-766, 1986.
91. Yamaguchi, D. M.; Lipscomb, P. R.; and Soule, E. H.: Carpal tunnel syndrome. Minnesota Med., 48: 22-33, 1965.
92. Yamamoto, S.; Ochi, M.; Shu, N.; Ryoke, K.; and Yamaguchi, H.: Expression of cytokines in the dorsal root ganglion cell body in an experimental model of entrapment neuropathy. Hand Surg., 3:175-183, 1988.
93. Yoshizawa, H.; Kobayashi, S.; and Morita, T.: Chronic nerve root compression. Pathophysiologic mechanism of nerve root dysfunction. Spine, 20: 397-407, 1995.