US4662884A
Expired / Lapsed
US
⏱️ 0.0 years remaining
Prostheses and methods for promoting nerve regeneration
Assignee: University of Utah Research Foundation Inc
•
Filing: 1984-04-25
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Granted: 1987-05-05
•
Expires: 2004-04-25
Abstract
Abstract The present invention is directed to prostheses and methods for promoting nerve regeneration. The proximal and distal ends of a severed nerve are brought into close proximity and are enclosed by a tubular prosthesis. In one preferred embodiment, a monosuture is used to hold the nerve ends in close proximity. A tight seal is formed between the prosthesis and the injured nerve so as to isolate the injured nerve within the prosthesis from the rest of the body of the host. Additionally, in one preferred embodiment, nerve grafts may be incorporated into the prosthesis and nerve regeneration promoting substances may be incorporated within the nerve graft to further enhance nerve regeneration. Prostheses and methods for inhibiting the formation of neuromas are also disclosed.
Inventors
- 👤 Larry J. Stensaas
- 👤 R. Joseph Todd
- 👤 Philip M. Triolo
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-22 22:10
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/02; A61F2/04; A61B; A61B17/00; A61B17/11; A61B17/1128; A61F2/30; A61F2002/30001; A61F2002/30108; A61F2002/30199; A61F2002/30224; A61F2002/30235; A61F2230/00; A61F2230/0063; A61F2230/0069
Claims Analysis
Total Claims: 31
Claim 1
Independent Claim
204 words
A method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent prosthesis which is substantially impermeable to fluids associated with nerve tissue, the impermeable prosthesis serving to substantially prevent the escape of trophic substances through the prosthesis and to substantially prevent the misrouting of regenerating axons out of the prosthesis upon installation of the prosthesis, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the prosthesis so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the prosthesis; inserting a proximal end of a severed nerve in a first end of the prosthesis; inserting a distal end of the severed nerve in a second end of the prosthesis; bringing the proximal end of the severed nerve into close proximity with the distal end of the severed nerve; and allowing the prosthesis to close around the severed nerve such that the prosthesis forms a close, fluid-tight seal around the proximal end of the severed nerve so as to substantially prevent trophic substances within the prosthesis from escaping out of the prosthesis.
Claim 2
Independent Claim
204 words
A method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent prosthesis which is substantially impermeable to fluids associated with nerve tissue, the impermeable prosthesis serving to substantially prevent the escape of trophic substances through the prosthesis and to substantially prevent the misrouting of regenerating axons out of the prosthesis upon installation of the prosthesis, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the prosthesis so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the prosthesis; inserting a proximal end of a severed nerve in a first end of the prosthesis; inserting a distal end of the severed nerve in a second end of the prosthesis; bringing the proximal end of the severed nerve into close proximity with the distal end of the severed nerve; and allowing the prosthesis to close around the severed nerve such that the prosthesis forms a close, fluid-tight seal around the proximal end of the severed nerve so as to substantially prevent trophic substances within the prosthesis from escaping out of the prosthesis.
Claim 3
Dependent Claim
33 words
A method as defined in claim 1 wherein the prosthesis serves to maintain the proximal end of the nerve within at least about 0.5 millimeters from the distal end of the severed nerve.
Claim 4
Dependent Claim
29 words
A method as defined in claim 1 wherein the first end of the prosthesis extends over the proximal end of the severed nerve by at least about 5 millimeters.
Claim 5
Dependent Claim
29 words
A method as defined in claim 1 wherein the second end of the prosthesis extends over the distal end of the severed nerve by at least about 2 millimeters.
Claim 6
Dependent Claim
37 words
A method as defined in claim 1 further comprising the step of maintaining the proximal end of the severed nerve in close proximity with the distal end of the severed nerve without suturing the nerve ends together.
Claim 7
Dependent Claim
35 words
A method as defined in claim 1 further comprising the step of using a monosuture to maintain the proximal end of the severed nerve in close proximity with the distal end of the severed nerve.
Claim 8
Dependent Claim
42 words
A method as defined in claim 1 further comprising the step of applying a localized crush along the proximal nerve end at a point located at about 1-2 centimeters from the point of severance before enclosing the nerve ends in the prosthesis.
Claim 9
Dependent Claim
43 words
A method as defined in claim 1 wherein the thickness of the wall of the prosthesis is in the range of from about 30% to about 50% of the inner diameter of the prosthesis, the wall of the prosthesis being resilient yet renitent.
Claim 10
Independent Claim
247 words
A method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent tube which is bicompatible and which is substantially impermeable to fluids associated with nerve tissue, the impermeable tube serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the tube; inserting a proximal end of a severed nerve through the slit into a first end of the tube; inserting a distal end of the severed nerve through the slit into a second end of the tube; positioning the proximal end of the severed nerve within at least about 0.5 millimeters from the distal end of the severed nerve; using a monosuture to maintain the proximal end of the severed nerve in close proximity with the distal end of the severed nerve; and allowing the tube to close around the severed nerve such that the tube forms a close, fluid-tight seal around the proximal end and the distal end of the severed nerve so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 11
Independent Claim
247 words
A method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent tube which is bicompatible and which is substantially impermeable to fluids associated with nerve tissue, the impermeable tube serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the tube; inserting a proximal end of a severed nerve through the slit into a first end of the tube; inserting a distal end of the severed nerve through the slit into a second end of the tube; positioning the proximal end of the severed nerve within at least about 0.5 millimeters from the distal end of the severed nerve; using a monosuture to maintain the proximal end of the severed nerve in close proximity with the distal end of the severed nerve; and allowing the tube to close around the severed nerve such that the tube forms a close, fluid-tight seal around the proximal end and the distal end of the severed nerve so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 12
Dependent Claim
42 words
A method as defined in claim 9 further comprising the step of: applying a localized crush along the proximal nerve end at a point located at about 1-2 centimeters from the point of severance before enclosing the nerve ends in the tube.
Claim 13
Independent Claim
285 words
a method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent tube which is substantially impermeable to fluids associated with nerve tissue, the impermeable tude serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to subtantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the tube; positioning a nerve graft within the tube; inserting a proximal end of a severed nerve through the slit into a first end of the tube such that the proximal end is positioned in close proximity to a first end of the nerve graft; inserting a distal end of the severed nerve through the slit into a second end of the tube such that the distal end is positioned in close proximity to a second end of the nerve graft; forming a monosuture to maintain the proximal end of the severed nerve in close proximity to the first end of the nerve graft and to maintain the distal end of the severed nerve in close proximity to the second end of the nerve graft; and allowing the tube to close around the severed nerve and the nerve graft such that the tube forms a close, fluid-tight seal around the proximal end of the severed nerve so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 14
Independent Claim
285 words
a method of promoting nerve repair, comprising the steps of: providing a resilient yet renitent tube which is substantially impermeable to fluids associated with nerve tissue, the impermeable tude serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to subtantially prevent the escape of trophic substances along the slit when the longitudinal edges are in the closed position; opening the longitudinal edges of the tube; positioning a nerve graft within the tube; inserting a proximal end of a severed nerve through the slit into a first end of the tube such that the proximal end is positioned in close proximity to a first end of the nerve graft; inserting a distal end of the severed nerve through the slit into a second end of the tube such that the distal end is positioned in close proximity to a second end of the nerve graft; forming a monosuture to maintain the proximal end of the severed nerve in close proximity to the first end of the nerve graft and to maintain the distal end of the severed nerve in close proximity to the second end of the nerve graft; and allowing the tube to close around the severed nerve and the nerve graft such that the tube forms a close, fluid-tight seal around the proximal end of the severed nerve so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 15
Dependent Claim
24 words
A method as defined in claim 11 further comprising the step of securing the tube closely around the second end of the nerve graft.
Claim 16
Dependent Claim
32 words
A method as defined in claim 11 further comprising the step of treating the nerve graft with deionized water to remove histocompatibility factors prior to positioning the nerve graft within the tube.
Claim 17
Dependent Claim
17 words
A method as defined in claim 11 wherein the nerve graft is obtained from a bovine source.
Claim 18
Dependent Claim
16 words
A method as defined in claim 11 wherein the nerve graft is obtained from a rabbit.
Claim 19
Dependent Claim
22 words
A method as defined in claim 11 further comprising the step of filling the nerve graft with a nerve regeneration promoting substance.
Claim 20
Dependent Claim
15 words
A method as defined in claim 16 wherein the nerve regeneration promoting substance comprises fibronectin.
Claim 21
Dependent Claim
17 words
A method as defined in claim 16 wherein the nerve regeneration promoting substance comprises an angiogenesis factor.
Claim 22
Dependent Claim
17 words
A method as defined in claim 16 wherein the nerve regeneration promoting substance comprises nerve growth factor.
Claim 23
Dependent Claim
18 words
A method as defined in claim 16 wherein the nerve regeneration promoting substance comprises central nervous system tissue.
Claim 24
Dependent Claim
16 words
A method as defined in claim 16 wherein the nerve regeneration promoting substance comprises Schwann cells.
Claim 25
Dependent Claim
58 words
A method as defined in claim 11 wherein the tube serves to maintain the proximal end of the severed nerve within at least about 0.5 millimeters from the first end of the nerve graft and to maintain the distal end of the severed nerve within at least about 0.5 millimeters from the second end of the nerve graft.
Claim 26
Dependent Claim
29 words
A method as defined in claim 11 wherein the first end of the tube extends over the proximal end of the severed nerve by at least about 5 millimeters.
Claim 27
Dependent Claim
29 words
A method as defined in claim 11 wherein the second end of the tube extends over the distal end of the severed nerve by at least about 2 millimeters.
Claim 28
Dependent Claim
61 words
A method as defined in claim 11 further comprising the step of maintaining the proximal end of the severed nerve in close proximity with the first end of the nerve graft and maintaining the distal end of the severed nerve in close proximity with the second end of the nerve graft without suturing the severed nerve ends to the nerve graft.
Claim 29
Independent Claim
332 words
A method of promoting nerve regeneration, comprising the steps of: providing a resilient yet renitent tube which is biocompatible and which is substantially impermeable to fluids associated with nerve tissue, the impermeable tube serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinally edges are in the closed position; opening the longitudinal edges of the tube; positioning a nerve graft within the tube; filling the nerve graft with a nerve regeneration promoting substance; inserting a proximal end of a severed nerve through the slit into a first end of the tube such that the proximal end is positioned within at least about 0.5 millimeters from a first end of the nerve graft; inserting a distal end of the severed nerve through the slit into a second end of the tube such that the distal end is positioned within at least about 0.5 millimeters away from a second end of the nerve graft; forming a monosuture to maintain the proximal end of the severed nerve in close proximity to the first end of the nerve graft and to maintain the distal end of the severed nerve in close proximity to the second end of the nerve graft; and allowing the tube to close around the severed nerve and the nerve graft such that the tube forms a close, fluid-tight seal around the proximal end and the distal end of the severed nerve and such that the tube forms a close, fluid-tight seal around the first end and the second end of the nerve graft so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 30
Independent Claim
332 words
A method of promoting nerve regeneration, comprising the steps of: providing a resilient yet renitent tube which is biocompatible and which is substantially impermeable to fluids associated with nerve tissue, the impermeable tube serving to substantially prevent the escape of trophic substances through the tube and to substantially prevent the misrouting of regenerating axons out of the tube upon installation of the tube, thereby substantially preventing the formation of a neuroma; forming a longitudinal slit along the length of the tube so as to form two longitudinal edges which abut so as to substantially prevent the escape of trophic substances along the slit when the longitudinally edges are in the closed position; opening the longitudinal edges of the tube; positioning a nerve graft within the tube; filling the nerve graft with a nerve regeneration promoting substance; inserting a proximal end of a severed nerve through the slit into a first end of the tube such that the proximal end is positioned within at least about 0.5 millimeters from a first end of the nerve graft; inserting a distal end of the severed nerve through the slit into a second end of the tube such that the distal end is positioned within at least about 0.5 millimeters away from a second end of the nerve graft; forming a monosuture to maintain the proximal end of the severed nerve in close proximity to the first end of the nerve graft and to maintain the distal end of the severed nerve in close proximity to the second end of the nerve graft; and allowing the tube to close around the severed nerve and the nerve graft such that the tube forms a close, fluid-tight seal around the proximal end and the distal end of the severed nerve and such that the tube forms a close, fluid-tight seal around the first end and the second end of the nerve graft so as to substantially prevent trophic substances within the tube from escaping out of the tube.
Claim 31
Dependent Claim
42 words
A method as defined in claim 26 further comprising the step of: applying a localized crush along the proximal nerve end at a point located at about 1-2 centimeters from the point of severance before inserting the nerve ends into the tube.
References Cited (Backward Citations)
US1308799A
Cited
US397861A
Cited
US783031A
Cited
US947146A
Cited
US1151300A
Cited
US1217637A
Cited
US1329121A
Cited
US1470707A
Cited
US2015509A
Cited
US2071250A
Cited
US1983601A
Cited
US2127903A
Cited
US2332826A
Cited
US2451703A
Cited
US2453056A
Cited
US2514665A
Cited
US2764683A
Cited
US2737402A
Cited
US3048177A
Cited
US3155095A
Cited
US3254650A
Cited
US3157181A
Cited
US3221746A
Cited
US3317924A
Cited
US3320947A
Cited
US3387608A
Cited
US3357432A
Cited
US3272204A
Cited
US3479670A
Cited
US3405715A
Cited
US3626926A
Cited
US3561448A
Cited
US3718134A
Cited
US3648295A
Cited
US3724467A
Cited
US3896817A
Cited
US3677243A
Cited
US3918459A
Cited
US3786817A
Cited
US3841306A
Cited
US3841305A
Cited
US3974835A
Cited
US3883901A
Cited
US3822708A
Cited
US3805793A
Cited
US3915151A
Cited
US3938528A
Cited
US3833002A
Cited
US3916905A
Cited
US3960151A
Cited
US3955560A
Cited
US4057069A
Cited
US4279256A
Cited
US4052978A
Cited
US4026300A
Cited
US4019519A
Cited
US4019518A
Cited
US4056097A
Cited
US4141365A
Cited
US4157087A
Cited
US4245638A
Cited
US4331150A
Cited
US4267842A
Cited
US4306561A
Cited
US4331157A
Cited
US4379665A
Cited
US4458678A
Cited
US4534349A
Cited
USPTO Annuity & Maintenance Windows
| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
|---|---|---|---|---|---|
| 3.5 Years (Year 4) | 1990-05-04 | 1990-11-03 | 1991-05-05 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 1994-05-04 | 1994-11-03 | 1995-05-05 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 1998-05-04 | 1998-11-03 | 1999-05-05 | $7700.00 | Window Closed / Lapsed |