Peker Fatih, Solakoğlu Can, Yuksel Fuat, Kutlay Murat
Department of Plastic and Reconstructive Surgery, Orthopaedics, and Neurosurgery, Gülhane Military Medical Academy and Medical School, Haydarpaşa Hospital, Istanbul, Turkey.
J Reconstr Microsurg. 2005 Feb;21(2):145-9. doi: 10.1055/s-2005-864849.
Partial nerve severance is a problem in peripheral-nerve surgery. It should be repaired without tension for a good functional result. There is usually no trouble in repairing acute injuries. But, as time passes, it may be difficult to establish a proper end-to-end repair, and this cause more tension at the repair sites. In this study, the critical time lapse for a deleterious effect was evaluated. Thirty rats were used, with partial nerve severance repaired immediately or at 10 or 20 days later. At 2, 4, 8, 12, 20, and 28 weeks, functional assessment of nerve regeneration was performed using walking-track analysis. Functionally, the sciatic index values were very close to each other in the immediate and 10-day-delay group, but the difference between these groups and the 20-day-delay group was statistically significant. The study suggests a critical period of about 2 weeks after partial nerve section before irreversible changes occur. Although this is not applicable to human models, it implies further work on a primate model for determining a reliable time-lapse period.
部分神经切断是周围神经外科手术中的一个问题。为获得良好的功能结果，应在无张力的情况下进行修复。修复急性损伤通常没有困难。但是，随着时间的推移，可能难以进行适当的端端修复，这会在修复部位产生更大的张力。在本研究中，评估了产生有害影响的关键时间间隔。使用了30只大鼠，部分神经切断后立即或在10天或20天后进行修复。在2、4、8、12、20和28周时，使用行走轨迹分析对神经再生进行功能评估。在功能上，立即修复组和延迟10天修复组的坐骨神经指数值非常接近，但这两组与延迟20天修复组之间的差异具有统计学意义。该研究表明，在部分神经切断后约2周内存在一个关键时期，在此之前不会发生不可逆的变化。尽管这不适用于人体模型，但它意味着需要在灵长类动物模型上进一步开展工作，以确定一个可靠的时间间隔。
