Regeneration of peripheral nerve gaps with a polyglycolic acid-collagen tube
Regeneration of peripheral nerve gaps with a polyglycolic acid-collagen tube
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DOI：
10.1227/01.neu.0000134388.86603.11
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发表时间：
2004-09-01
期刊：
影响因子：
4.8
通讯作者：
Nakamura, T
中科院分区：
文献类型：
--
作者：
Inada, Y;Morimoto, S;Nakamura, T
目的：本研究的目的是通过客观方法报告两名患者使用生物可吸收管进行神经重建手术的有效性。我们以前的成功再生犬周围神经在长距离（80毫米的差距）使用生物可吸收管，使我们调查这样的管的价值，用于治疗人类患者的慢性神经injuries.METHODS：该设备是由一个圆柱形编织聚乙醇酸管填充胶原海绵。它被设计成在神经再生后被再吸收。应用该管重建了2例神经瘤伴疼痛患者的周围感觉神经缺损。患者1（一名62岁的男子）有一个20毫米的缺陷，适当的数字神经，和患者2（一名56岁的妇女）有一个65毫米的缺陷腓浅神经。结果：手术后，两名患者恢复的不愉快的感觉和无法忍受的疼痛。在患者1中，在2个月时客观地确定了功能恢复，神经的传导速度恢复到49.1 m/s。在患者2中，在5个月时确定神经的传导速度为16.9 m/s。电流感觉阈值测试表明，术后65天感觉神经功能已恢复。这项工作代表了第一个精确的临床评估，在客观的评估标准下进行，使用神经管实现感觉恢复，这表明使用聚乙醇酸-胶原管有可能成为传统自体移植修复周围神经缺损的可行替代物。
OBJECTIVE: The aim of this study was to report by means of objective methods on the effectiveness of a nerve reconstruction procedure using a bioresorbable tube in two patients. Our previous successes in regenerating canine peripheral nerves across long distances (80-mm gaps) using a bioabsorbable tube have led us to investigate the value of such a tube for the treatment of human patients with chronic nerve injuries.METHODS: The device was made from a cylindrically woven polyglycolic acid tube filled with a Collagen sponge. It was designed to be resorbed after nerve regeneration. Peripheral sensory nerve defects in two patients with neuroma and pain were reconstructed using this tube. Patient 1 (a 62-year-old man) had a 20-mm defect of the proper digital nerve, and Patient 2 (a 56-year-old woman) had a 65-mm defect of the superficial peroneal nerve.RESULTS: After surgery, both patients recovered from the unpleasant sensations and intolerable pain. In Patient 1, functional recovery was objectively identified at 2 months, and conduction velocity of the nerve recovered to 49.1 m/s. In Patient 2, conduction velocity of the nerve was determined to be 16.9 m/s at 5 months. Current perception threshold testing indicated that sensory nerve function had been recovered by 65 days after surgery.CONCLUSION: This work represents the first precise clinical evaluation, performed under objective evaluation criteria, of sensory recovery achieved using a nerve tube, suggesting that the use of a polyglycolic acid-collagen tube has the potential to become a viable alternative to conventional autografting for the repair of peripheral nerve defects.