Application of Extradural Nerve Root Transfer in the Restoration of Lower Limb Function in Spinal Cord Injury: Hypothesis and a Cadaver Feasibility Study.
Application of Extradural Nerve Root Transfer in the Restoration of Lower Limb Function in Spinal Cord Injury: Hypothesis and a Cadaver Feasibility Study.
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硬膜外神经根移植在脊髓损伤下肢功能恢复中的应用：假设和尸体可行性研究。
DOI：
10.1097/brs.0000000000004013
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Xiaojian Cao
中科院分区：
文献类型：
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作者：
Hongtao Chen;Jiang Cao;Sheng Zhang;Tao Sui;Kaixiang Yang;Xiaojian Cao
研究设计：本研究包括2具新鲜冷冻身体和6具福尔马林固定身体。目的：探讨脊髓损伤后将T9或T11前根移植到L2和T10或T12移植到L3重建肢体功能的解剖学可行性。方法：在本研究中，对2具新鲜冷冻身体和6具福尔马林固定身体进行了解剖，以证实其解剖学可行性。有限椎板切除暴露T9-L3硬膜外神经根。T9、T10 VR分别与L2、L3 VR吻合，T11、T12 VR分别与L2、L3 VR吻合。测量供体神经与受体神经之间的距离，并用H&E染色测量各VR的轴突数目和横截面积。根据背根神经节的解剖标志，可以从每个硬膜外神经根分离出每个VR。T9或T11 VR需要腓肠神经移植物移植到L2 VR，T10或T12 VR也需要神经桥接L3 VR。分别测量T9、T10、T11、T12、L2、L3VRS和腓肠神经的神经数。分别测量T9、T10、T11、T12、L2、L3VR横截面积和腓肠神经横截面积。结论：本研究提示T9或T11 VR移植到L2 VR，T10或T12 VR移植到L3 VR恢复肢体功能在解剖学上是可行的。证据水平：5本研究旨在明确T9或T11前根移植到L2前根，T10或T12腹根移植到L3前根是否具有解剖学上的可行性。通过2具新鲜冷冻身体和6具福尔马林固定身体验证了该方法的可行性。
Study Design.Two fresh-frozen and six formalin-fixed cadavers were included in the study.Objective.To ascertain whether transferring T9 or T11 ventral root (VR) to L2 VR and T10 or T12 VR to L3 VR in restoring lower limb function after spinal cord injury is anatomically feasible.Summary of Background Data.Lower limb paralysis impairs the quality of the life and places burden on the whole society. However, no significant improvement in this area was achieved during recent years.Methods.In the present study, two fresh-frozen and six formalin-fixed cadavers were dissected to confirm the anatomical feasibility. A limited laminectomy was performed to expose the T9–L3 extradural nerve roots. T9 and T10 VR were anastomosed to L2 and L3 VR respectively, or T11 and T12 VR were anastomosed to L2 and L3 VR respectively. The pertinent distances between the donor and recipient nerves were measured and H&E staining was used to detect the axon number and cross-section area of each VR.Results.The limited incision was performed to expose the T9–L3 nerve root. According to the anatomic landmark of dorsal root ganglion, each VR could be isolated from each extradural nerve root. The T9 or T11 VR needs sural nerve graft to be transferred to L2 VR, and T10 or T12 VR also needs a nerve bridge to connect to L3 VR. The nerve numbers of T9, T10, T11, T12, L2, and L3 VRs and the sural nerves were measured respectively. The cross-section areas of T9, T10, T11, T12, L2, and L3 VRs and sural nerves were measured respectively.Conclusion.Our study suggested that application of transferring T9 or T11 VR to L2 VR and T10 or T12 VR to L3 VR in restoring lower limb function is anatomically feasible.Level of Evidence: 5This study was aimed to ascertain whether transferring T9 or T11 ventral roots to L2 ventral roots and T10 or T12 ventral roots to L3 ventral roots in restoring lower limb function after spinal cord injury is anatomically feasible. The feasibility was verified by two fresh-frozen and six formalin-fixed cadavers.