Promoting nerve regeneration through long gaps by using small piece graft of nerve tissue

根据神经趋向性的概念，将一小块神经组织移植到硅胶管中，以桥接相对较长的神经间隙，试图实现神经再生。取8周龄Wistar大鼠33只，左侧坐骨神经形成15 mm的缝隙。实验组包括未缝合神经的硅胶管移植组(NV-A)、未缝合远端神经的硅胶管移植组(V-A)、未缝合硅胶管的非血管化神经组织移植组(NV-P)、远端神经缝合硅胶管移植组(V-P)和硅胶管内未移植神经的对照组(对照组)。术后10周进行电生理和组织学检查。对照组无一例再生。神经再生在NV-A、V-A、NV-P和V-P组的近端有明显的神经再生，在NV-P和V-P组的远端有明显的神经再生。NV-A组和V-A组远端再生程度极轻。NV-P组和V-P组的电生理检查显示后者效果更好。这些结果表明，即使有较长的神经间隙，小段神经移植也能够诱导神经再生，方法是使用硅胶管将神经组织移植到损伤中心。

According to the concept of neurotropism a small piece of nerve tissue was grafted into a silicone tube placed to bridge a relatively long nerve gap in an attempt to attain nerve regeneration. A 15-mm gap was created in the left sciatic nerve of 33 Wistar rats (8 weeks of age). The experimental groups included one with nonvascularized nerve tissue grafted into a silicone tube with no distal nerve suturing (NV-A), another with vascularized nerve tissue grafted into a silicone tube with no distal nerve suturing (V-A), a third group with nonvascularized nerve tissue grafted into a silicone tube with distal nerve suturing (NV-P), a fourth group with vascularized nerve tissue grafted into a silicone tube with distal nerve suturing (V-P), and a group with no nerve segment grafted into the silicone tube (control). Electrophysiologic and histologic examinations were performed 10 weeks after the operation. No regeneration was obtained in the control group. Nerve regeneration was evident on the proximal defective site of the tube in the NV-A, V-A, NV-P and V-P groups, and on the distal side in the NV-P and V-P groups. The degree of distal regeneration was extremely slight in the NV-A and V-A groups. An electrophysiologic examination performed in the NV-P and V-P groups revealed better results in the latter group. These findings indicated that small nerve piece grafts were capable of inducing nerve regeneration even with a long nerve gap, by grafting nerve tissue in the middle of the lesion using a silicone tube.