End-to-side neurorrhaphies in a rodent model of peripheral nerve injury: a preliminary report of a novel technique
End-to-side neurorrhaphies in a rodent model of peripheral nerve injury: a preliminary report of a novel technique
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DOI：
10.3171/ped.2004.101.2.0078
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发表时间：
2004-08-01
影响因子：
4.1
通讯作者：
Nystrom, NA
中科院分区：
文献类型：
--
作者：
Adelson, PD;Bonaroti, EA;Nystrom, NA
Object.用于修复具有神经瘤形成的周围神经损伤的标准技术通常是次优的。为了开始探索替代技术，作者在啮齿动物中使用了一个已建立的模型，通过使用端侧“端侧”神经缝合术（TLN）来研究替代移植技术。TLN“跳跃移植物”绕过神经主连续性，假设维持神经瘤内的功能单位以促进功能再生。移植物内再生纤维的范围和来源的评价也被证实。采用挤压或横断技术损伤4只成年Sprague-Dawley大鼠的右侧胫神经，并与4只未损伤的对照组进行比较。所有动物均立即收获对侧腓总神经，采用TLN跳跃移植进行显微外科修复。术后恢复3个月，采用诱发肌电图（EMG）对修复神经进行电生理学评价。然后进行组织学制备，使用双荧光标记研究轴突再生和origin.Evoked肌电图评估证实了健康的电传导整个修复，这是不变的神经瘤横断后，但被取消后横断的跳跃移植，表明功能性神经再生跨越近端和远端TLN的跳跃移植。荧光追踪分析证实了跳跃移植物近端和远端部分的再生，证明运动神经元和感觉神经元都是再生纤维的来源，并证明了大量的双标记细胞体，表明侧支发芽是再生纤维的主要来源。结论。作者已经初步表明，再生发生在电生理和组织学与双TLN跳跃移植。在临床上，这种方法可以提供一种替代的策略，神经瘤修复的技术和时机。
Object. The standard techniques for repair of peripheral nerve injuries with neuroma formation are typically suboptimal. To begin to explore alternative techniques, the authors used an established model in rodents by using end-to-side "terminolateral" neurorrhaphies (TLNs) to study alternative grafting techniques. The TLN "jump grafts" bypass a neuro-main-continuity, hypothetically maintaining functional units within the neuroma to facilitate functional regeneration. Evaluation of the extent and origin of the regenerating fibers within the grafts was also undertaken.Methods. The right tibial nerve in four adult Sprague-Dawley rats was injured using either a crush or transection technique and compared with four uninjured controls, The contralateral peroneal nerve was immediately harvested for microsurgical repair by using TLN jump grafts in all animals. Following a 3-month recovery, the repaired nerves were evaluated electrophysiologically by using evoked electromyography (EMG). Histological preparation was then performed using dual-fluorescent labeling to study axonal regeneration and origins.Evoked EMG evaluation confirmed healthy electrical conduction across the repair, which was unchanged after transection of the neuroma, but was abolished after transection of the jump graft, indicating functional neural regeneration across both the proximal and distal TLNs of the jump grafts. Fluorescent tracing analysis confirmed regeneration across both the proximal and distal portion of the jump grafts, demonstrated both motor and sensory neurons as the source of the regenerating fibers, and demonstrated significant numbers of double-labeled cell bodies, indicating that collateral sprouting was the primary source of regenerating fibers.Conclusions. The authors have preliminarily shown that regeneration occurs both electrophysiologically and histologically with a double-TLN jump graft. Clinically, this method could offer an alternative strategy for the technique and timing of neuroma repair.