Liu S, Aghakhani N, Boisset N, Said G, Tadie M
Laboratory of Experimental Neurosurgery, Faculté de M ecine Paris-Sud, University of Paris XI, France.
J Neurosurg. 2001 Jan;94(1 Suppl):82-90. doi: 10.3171/spi.2001.94.1.0082.
The authors conducted a study to determine the effects of using a nerve autograft (NAG) to promote and guide axonal regrowth from the rostral spinal cord to the caudal lumbar ventral nerve roots to restore hindlimb motor function in adult marmosets after lower thoracic cord injury.
Nine animals underwent a left-sided hemisection of the spinal cord at T-12 via left-sided T9-L3 hemilaminectomy, with section of all ipsilateral lumbrosacral ventral nerve roots. In the experimental group (five animals), an NAG obtained from the right peroneal nerve was anastomosed with the sectioned and electrophysiologically selected lumbar ventral roots (left L-3 and L-4) controlling the left quadriceps muscle and then implanted into the left ventrolateral T-10 cord. In the control group (four animals), the sectioned/selected lumbar ventral roots were only ligated. After surgery, all marmosets immediately suffered from complete paralysis of their left hindlimb. Five months later, some clinical signs of reinnervation such as tension and resistance began to appear in the paralyzed quadriceps of all experimental animals that received autografts. Nine months postoperatively, three of the five experimental marmosets could maintain their lesioned hindlimb in hip flexion. Muscle action potentials and motor evoked potentials were recorded from the target quadriceps in all experimental marmosets, but these potentials were absent in the control animals. Horseradish peroxidase retrograde labeling from the distal sectioned/reconnected lumbar ventral roots traced 234+/-178 labeled neurons in the ipsilateral T8-10 ventral horn, mainly close to the NAG tip. Histological analysis showed numerous regenerating axons in this denervated/reconnected nerve root pathway, as well as newly formed motor endplates in the denervated/reinnervated quadriceps. No axonal regeneration was detected in the control animals.
These data indicate that the rostral spinal neurons can regrow into the caudal ventral roots through an NAG, thereby innervating the target muscle in adult marmosets after spinal cord injury.
作者开展了一项研究，以确定使用自体神经移植物（NAG）促进和引导轴突从脊髓头端向腰段尾侧腹侧神经根生长，从而恢复成年狨猴胸段脊髓下部损伤后后肢运动功能的效果。
9只动物通过左侧T9-L3半椎板切除术在T-12水平进行脊髓左侧半横断，并切断所有同侧腰骶腹侧神经根。在实验组（5只动物）中，取自右侧腓神经的NAG与切断并经电生理选择的控制左股四头肌的腰腹侧神经根（左L-3和L-4）进行吻合，然后植入左侧T-10脊髓腹外侧。在对照组（4只动物）中，仅结扎切断/选择的腰腹侧神经根。手术后，所有狨猴立即出现左后肢完全瘫痪。5个月后，所有接受自体移植的实验动物瘫痪的股四头肌开始出现一些再支配的临床体征，如张力和阻力。术后9个月，5只实验狨猴中有3只能够使损伤的后肢保持髋关节屈曲。在所有实验狨猴的目标股四头肌中记录到肌肉动作电位和运动诱发电位，但对照组动物未记录到这些电位。从远端切断/重新连接的腰腹侧神经根进行辣根过氧化物酶逆行标记，在同侧T8-10腹角追踪到234±178个标记神经元，主要靠近NAG尖端。组织学分析显示，在这条失神经/重新连接的神经根通路中有大量再生轴突，以及失神经/再支配的股四头肌中有新形成的运动终板。对照组动物未检测到轴突再生。
这些数据表明，脊髓头端神经元可通过NAG向尾侧腹侧神经根生长，从而在成年狨猴脊髓损伤后支配目标肌肉。
