Maki Yutaka
Niigata Hand Surgery Foundation, 1-18 Shinko-cho, Niigata 950-8556, Japan.
J Orthop Sci. 2002;7(5):594-600. doi: 10.1007/s007760200107.
Epineurial and epiperineurial nerve suturing with orientation of the intraneurial funicular pattern are the only useful nerve repair techniques. The research on axonal regeneration was reviewed to determine whether basic research findings may support a new clinical approach to nerve repair. The research indicates that Schwann cell migration from the distal nerve stump is important in tissue specificity; sensory regeneration, but not motor regeneration, shows selectivity; sensory Schwann cells in the distal nerve segment induce not only sensory axons but also motor axons, which are the strongest 1 week after denervation and are influenced by the stump area and the volume of the distal nerve segment; and evidence of topographic specificity is weak. The strong inductive ability of sensory Schwann cells to misdirect motor nerve regeneration to the distal sensory Schwann tubes may not support the use of tube techniques for nerve repair.
神经束膜和神经束膜外神经缝合术结合神经束内索状模式的定向是仅有的有用的神经修复技术。对轴突再生的研究进行了综述，以确定基础研究结果是否能支持一种新的神经修复临床方法。研究表明，雪旺细胞从远端神经残端的迁移在组织特异性中很重要；感觉再生而非运动再生具有选择性；远端神经节段中的感觉雪旺细胞不仅诱导感觉轴突，还诱导运动轴突，这种诱导在去神经支配后1周最强，并受残端面积和远端神经节段体积的影响；而且地形特异性的证据不足。感觉雪旺细胞将运动神经再生错误引导至远端感觉雪旺管的强大诱导能力可能不支持使用导管技术进行神经修复。
