Limitations of nerve repair of segmental defects using acellular conduits Case report
Limitations of nerve repair of segmental defects using acellular conduits Case report
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DOI：
10.3171/2013.4.jns121938
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发表时间：
2013-09-01
影响因子：
4.1
通讯作者：
Levi, Allan D.
中科院分区：
文献类型：
--
作者：
Berrocal, Yerko A.;Almeida, Vania W.;Levi, Allan D.
作者介绍了一名 20 岁男性的案例，他在初次受伤 3 个月后接受了手腕处尺神经 1.7 厘米缺损的修复术；使用无细胞同种异体神经移植物进行修复。鉴于修复后 8 个月没有临床或电生理恢复，患者接受了重新探查、切除“再生电缆”，并用腓肠神经自体移植物重新修复尺神经。电缆的组织学显示在修复的中点轴突再生最少。在腓肠神经移植修复的 6 个月和 12 个月的随访中，尺神经和相关手部肌肉的感觉和运动神经支配的临床和电生理学证据得到了证实。在这份报告中，作者描述了一个失败的无细胞同种异体神经移植病例，并将结果与基础科学和人类研究相关联，这些研究报告了利用缺乏活雪旺细胞的移植物或导管修复人类神经的长度和直径限制。
The authors present the case of a 20-year-old man who, 3 months after his initial injury, underwent repair of a 1.7-cm defect of the ulnar nerve at the wrist; repair was performed with an acellular nerve allograft. Given the absence of clinical or electrophysiological recovery at 8 months postrepair, the patient underwent reexploration, excision of the "regenerated cable," and rerepair of the ulnar nerve with sural nerve autografts. Histology of the cable demonstrated minimal axonal regeneration at the midpoint of the repair. At the 6- and 12-month follow-ups of the sural nerve graft repair, clinical and electrophysiological evidence of both sensory and motor reinnervation of the ulnar nerve and associated hand muscles was demonstrated. In this report, the authors describe a single case of failed acellular nerve allograft and correlate the results with basic science and human studies reporting length and diameter limitations in human nerve repair utilizing grafts or conduits devoid of viable Schwann cells.