Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 2, 2012
   Pages 309 — 322

Abstract — Human distal sciatic nerve fascicular anatomy: Implications for ankle control using nerve-cuff electrodes

Kenneth J. Gustafson, PhD;1–2* Yanina Grinberg, MS;1 Sheeba Joseph, BS;3 Ronald J. Triolo, PhD1–2,4

1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; 2Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; 3Case Western Reserve University School of Medicine, Cleveland, OH; 4Department of Orthopedics, Case Western Reserve University, Cleveland, OH

Abstract–The design of neural prostheses to restore standing balance, prevent foot drop, or provide active propulsion during ambulation requires detailed knowledge of the distal sciatic nerve anatomy. Three complete sciatic nerves and branches were dissected from the piriformis to each muscle entry point to characterize the branching patterns and diameters. Fascicle maps were created from serial sections of each distal terminus below the knee through the anastomosis of the tibial and common fibular nerves above the knee. Similar branching patterns and fascicle maps were observed across specimens. Fascicles innervating primary plantar flexors, dorsiflexors, invertors, and evertors were distinctly separate and functionally organized in the proximal tibial, common fibular, and distal sciatic nerves; however, fascicles from individual muscles were not apparent at these levels. The fascicular organization is conducive to selective stimulation for isolated and/or balanced dorsiflexion, plantar flexion, eversion, and inversion through a single multicontact nerve-cuff electrode. These neuroanatomical data are being used to design nerve-cuff electrodes for selective control of ankle movement and improve current lower-limb neural prostheses.

Key words: anatomy, ankle, common fibular, cuff, electrode, nerve, prosthesis, rehabilitation, sciatic, tibial.


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