Koizumi Masahiro, Maki Yutaka, Yoshizu Takae, Tsubokawa Naoto
Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Hand Surg. 2004 Dec;9(2):151-7. doi: 10.1142/s0218810404002200.
We examined the influence of misdirection of regenerating motor axons toward the distal sensory Schwann tubes on the muscle contraction force in early nerve repair using a rat sciatic nerve model. At 0, 1, 2, 4 and 8 weeks after severing the tibial, peroneal and sural nerves, the proximal stump of the tibial nerve was anastomosed with the distal stumps of both the peroneal and sural nerves using tubulisation (n=10 in each of five groups). We intentionally used the distal stump of the sural nerve (a sensory nerve) to induce regeneration in motor axons from the proximal tibial nerve stump toward the distal sensory nerve stump. Twenty-four weeks after nerve repair, isometric contraction force and wet weight of the anterior tibial muscle were measured, and the numbers of regenerated myelinated axons (motor and sensory) in the distal sural and peroneal nerves were counted. The rates of sural nerve regeneration were significantly higher at weeks 0 and 1 than at the later repair times. However, muscle contraction force and muscle wet weight did not differ significantly between groups in which nerves were repaired within four weeks of severance. These results indicate that peripheral nerve repair within four weeks of severance does not influence the muscle contraction force of single muscle despite the misdirection of motor axons toward the distal sensory Schwann tubes.
我们使用大鼠坐骨神经模型，研究了在早期神经修复过程中，再生运动轴突误向远端感觉施万管生长对肌肉收缩力的影响。切断胫神经、腓总神经和腓肠神经后0、1、2、4和8周，采用套管法将胫神经近端残端与腓总神经和腓肠神经的远端残端进行吻合（五组，每组n = 10）。我们故意利用腓肠神经（感觉神经）的远端残端，诱导运动轴突从胫神经近端残端向远端感觉神经残端生长。神经修复24周后，测量胫前肌的等长收缩力和湿重，并计数远端腓肠神经和腓总神经中再生有髓轴突（运动和感觉）的数量。腓肠神经再生率在0周和1周时显著高于后期修复时间。然而，在神经切断后四周内进行修复的各组之间，肌肉收缩力和肌肉湿重没有显著差异。这些结果表明，在切断后四周内进行周围神经修复，尽管运动轴突误向远端感觉施万管生长，但并不影响单块肌肉的收缩力。
