Variables affecting axonal regeneration following end-to-side neurorrhaphy
Variables affecting axonal regeneration following end-to-side neurorrhaphy
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DOI：
10.1054/bjps.1997.0188
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发表时间：
1998-04-01
期刊：
影响因子：
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通讯作者：
Al-Thunyan, A
中科院分区：
文献类型：
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作者：
Al-Qattan, MM;Al-Thunyan, A
神经端侧接合可以诱导侧支发芽的概念最近被Viterbo重新引入。然而，其他作者报道了与这种神经修复技术相矛盾的结果。本文研究了端侧修复后影响轴突再生的一些变量。研究的第一部分比较了采用神经外缝合线和神经外缝合线进行神经移植端侧吻合后的轴突再生率。采用大鼠坐骨神经模型，将新鲜的自体神经移植物缝合于完整的坐骨神经侧。将20只大鼠分为2组。A组（n=10）将神经移植物缝合于神经膜外膜。B组（n=10）缝合神经会阴。修复后50天对神经移植物进行组织学和电镜评价。A组神经移植物未见轴突再生。B组50%的移植物显示轴突再生。两组间差异有统计学意义。电镜显示神经端侧吻合后的修复过程在结构上与神经端侧吻合后的轴突再生相似。结论：当神经移植物与母神经采用神经周缝合线而非神经外缝合线时，端侧神经吻合后的轴突再生更容易发生。本研究的第二部分着重于探讨将硅胶管端侧缝合于完整坐骨神经的神经外膜或神经周围膜诱导侧支发芽的可行性。经过50天的恢复期后，暴露硅胶管附着部位并小心地取出硅胶管。硅胶管中含有的软组织牢固地附着在神经一侧，这被称为附着软组织段（ast）。组织学和电镜检查未见ast内神经再生的证据。在移植的硅胶管中没有雪旺细胞可以解释ast中没有侧枝发芽的原因。
The concept that end-to-side nerve coaptation can induce collateral sprouting was recently reintroduced by Viterbo. However, other authors have reported conflicting results with this technique of nerve repair The current paper studies some of the variables affecting axonal regeneration following end-to-side repair. The first part of the study compares the rate of axonal regeneration following end-to-side neurorrhaphy with nerve grafts using epineurial versus perineurial sutures. The rat sciatic nerve model was used and fresh autogenous nerve grafts were sutured to the side of intact sciatic nerves. A total of 20 rats were divided into 2 groups. In group A (n=10), suturing of the nerve graft was done to the epineurium. In group B (n=10), suturing was done to the perineurium. Histological and electron microscopic evaluation of the nerve grafts was done 50 days following the repair. In group A, none of the nerve grafts showed regenerating axons. In group B, 50% of grafts showed evidence of axonal regeneration. The difference between the two groups was statistically significant. Electron microscopy showed that the repair process following end-to-side neurorrhaphy was structurally similar to axonal regeneration following end-to-side neurorrhaphy. It was concluded that axonal regeneration following end-to-side nerve coaptation is mon likely to occur when the nerve graft is sutured to the parent nerve using perineurial rather than epineurial sutures. The second part of the study focused on investigating the feasibility of inducing collateral sprouting by silicone tubes sutured in an end-to-side fashion to the epineurium or perineurium of intact sciatic nerves. Following a 50-day recovery period, the site of silicone tube attachment was exposed and the tube carefully removed. The silicone tube contained soft tissue which was firmly attached to the side of the nerve and this was called the Attached Soft Tissue Segment (ASTS). Histological and electron microscopic examination showed no evidence of any nerve regeneration within the ASTS. The failure to demonstrate collateral sprouting within the ASTS may be explained by the absence of Schwann cells in the transplanted silicone tubes.