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The Journal of Bone and Joint Surgery 81:1600-10 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.


Current Concepts Review

Pathophysiology of Nerve Compression Syndromes: Response of Peripheral Nerves to Loading*

DAVID REMPEL, M.D., M.P.H.{dagger}, SAN FRANCISCO, CALIFORNIA, LARS DAHLIN, M.D., PH.D.{ddagger} and GÖRAN LUNDBORG, M.D., PH.D.{ddagger}, MALMÖ, SWEDEN


    Introduction
 
Nerve compression syndromes involve peripheral-nerve dysfunction that is due to localized interference of microvascular function and structural changes in the nerve or adjacent tissues. Although a well known example is compression of the median nerve at the wrist (carpal tunnel syndrome), other nerves, such as the ulnar nerve at the wrist or the elbow and the spinal nerve roots at the vertebral foramen, are vulnerable. This paper focuses on studies in which the physiological, pathophysiological, biochemical, and histological effects of biomechanical loading on the peripheral nerves were evaluated in humans and animals.

When tissues are subjected to load or pressure, they deform and pressure gradients are formed, redistributing the compressed tissue toward areas of lower pressure. Nerve compression syndromes usually occur at sites where the nerve passes through a tight tunnel formed by stiff tissue boundaries. The resultant confined space limits movement of tissue and can lead to sustained tissue . . . [Full Text of this Article]


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