The Effect of Severing L6 Nerve Root of the Sacral Plexus on Lower Extremity Function: An Experimental Study in Rhesus Monkeys
The Effect of Severing L6 Nerve Root of the Sacral Plexus on Lower Extremity Function: An Experimental Study in Rhesus Monkeys
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DOI：
10.1227/neu.0b013e31822c4b39
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发表时间：
2012-01
期刊：
影响因子：
4.8
通讯作者：
Haodong Lin;Zhen Xu;Yong Liu;Aimin Chen;C. Hou
中科院分区：
文献类型：
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作者：
Haodong Lin;Zhen Xu;Yong Liu;Aimin Chen;C. Hou
背景神经移位是腰骶丛撕脱伤后下肢功能恢复的有效手术方法。目的评价恒河猴L6神经根切断对健肢功能的影响，探讨以健侧L6神经根为供体神经修复腰骶丛神经根性撕脱伤的可行性。方法24只恒河猴随机分为2组。在实验组中，探查并切断右侧L6神经根，而在对照组中动物经历假手术。对靶肌肉进行电生理、肌肉质量、组织学和超微结构检查。结果切断后3周，实验组腓肠肌内侧肌、趾短伸肌、腓骨长肌和拇展肌的复合肌肉动作电位振幅降低、潜伏期延长，肌肉质量和肌纤维横截面积减少。实验组坐骨神经有髓神经纤维数明显少于对照组。实验组运动终板超微结构也有异常改变。术后8周，所有这些参数在实验组和对照组之间相似。结论切断L6神经根对健侧肢体的电生理、肌肉质量、组织学及超微结构无明显损害。L6神经根可作为腰骶丛神经根性撕脱伤的供体神经。
BACKGROUND Nerve transfer is a valid surgical procedure for lower-extremity function restoration after lumbosacral plexus avulsion. OBJECTIVE To evaluate the impact of severing the L6 nerve root on the functions of the healthy limb in rhesus monkeys and the feasibility of using the contralateral L6 nerve root as a donor nerve to repair lumbosacral plexus root avulsion. METHODS Twenty-four rhesus monkeys were randomly assigned into 2 groups. In the experimental group, the right L6 nerve root was explored and severed, whereas in the control group animals underwent a sham operation. Electrophysiology, muscle mass, histology, and ultrastructure of the target muscles were examined. RESULTS Three weeks after transection, reduced amplitude and prolonged latency of compound muscle action potential were observed in the medial gastrocnemius, extensor digitorum brevis, peroneus longus, and abductor hallucis muscles of the experimental group, as well as reduction in muscle mass and myofiber cross-sectional area of these muscles. The number of myelinated nerve fibers of the sciatic nerve in the experimental group was significantly less than that of the control group. Abnormal ultrastructure of motor end plates of these muscles was also observed in the experimental group. Eight weeks postoperatively, all of these parameters were similar between the experimental and control groups. CONCLUSION Severing the L6 nerve root does not damage the healthy limb as far as electrophysiology, muscle mass, histology, and ultrastructure of the target muscles are concerned. L6 (analogous to S1 in humans) nerve root may be used as a donor nerve to repair lumbosacral plexus root avulsion.