Rochkind Shimon, Leider-Trejo Leonor, Nissan Moshe, Shamir Merav H, Kharenko Oleg, Alon Malvina
Division of Peripheral Nerve Reconstruction, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
Photomed Laser Surg. 2007 Jun;25(3):137-43. doi: 10.1089/pho.2007.2076.
This pilot double-blind randomized study evaluated the efficacy of 780-nm laser phototherapy on the acceleration of axonal growth and regeneration after peripheral nerve reconstruction by polyglycolic acid (PGA) neurotube.
The use of a guiding tube for the reconstruction of segmental loss of injured peripheral nerve has some advantages over the regular nerve grafting procedure. Experimental studies have shown that laser phototherapy is effective in influencing nerve regeneration.
The right sciatic nerve was transected, and a 0.5-cm nerve segment was removed in 20 rats. A neurotube was placed between the proximal and the distal parts of the nerve for reconnection of nerve defect. Ten of 20 rats received post-operative, transcutaneous, 200-mW, 780-nm laser irradiation for 14 consecutive days to the corresponding segments of the spinal cord (15 min) and to the reconstructed nerve (15 min).
At 3 months after surgery, positive somato-sensory evoked responses were found in 70% of the irradiated rats (p = 0.015), compared to 30% of the non-irradiated rats. The Sciatic Functional Index in the irradiated group was higher than in the non-irradiated group (p < 0.05). Morphologically, the nerves were completely reconnected in both groups, but the laser-treated group showed an increased total number of myelinated axons.
The results of this study suggest that postoperative 780-nm laser phototherapy enhances the regenerative process of the peripheral nerve after reconnection of the nerve defect using a PGA neurotube.
本前瞻性双盲随机研究评估了780纳米激光光疗对聚乙醇酸(PGA)神经管修复周围神经后轴突生长和再生加速的疗效。
使用引导管修复受损周围神经的节段性缺损比常规神经移植手术具有一些优势。实验研究表明,激光光疗对神经再生有影响。
切断20只大鼠的右侧坐骨神经,切除0.5厘米长的神经段。在神经的近端和远端之间放置一个神经管以修复神经缺损。20只大鼠中的10只在术后接受经皮200毫瓦、780纳米激光照射,连续14天照射脊髓相应节段(15分钟)和修复的神经(15分钟)。
术后3个月,70%接受照射的大鼠出现阳性体感诱发电位反应(p = 0.015),而未照射大鼠为30%。照射组的坐骨神经功能指数高于未照射组(p < 0.05)。形态学上,两组神经均完全重新连接,但激光治疗组有髓鞘轴突总数增加。
本研究结果表明,术后780纳米激光光疗可增强使用PGA神经管修复神经缺损后周围神经的再生过程。