Kerns James M, Braverman Berton, Mathew Abraham, Lucchinetti Claudia, Ivankovich Anthony D
Department of Anatomy Rush Presbyterian St. Luke's Medical Center, Chicago, IL 60612 U.S.A. Department of Anesthesiology, Rush Presbyterian St. Luke's Medical Center, Chicago, IL 60612 U.S.A.
Pain. 1991 Oct;47(1):31-39. doi: 10.1016/0304-3959(91)90008-L.
This study examines the behavioral, sensory, motor and structural recovery during the first 2 months following a freeze (cryoprobe) lesion compared to a nerve crush (forceps). There is a complete loss of sensory and motor function following either type of lesion during the first 2 weeks of recovery. The toe spreading reflex and the sciatic functional index of locomotion behavior returned to normal without significant group differences. Latency times for the pain withdrawal reflex were slightly shorter in the cryoprobe group, but both groups returned to baseline during the second month. An improved regenerative pattern was suggested for the motor recovery in the cryoprobe group as expressed by the amplitude of the digital twitch tension curves. However, the respective curve areas were not different. Morphometric analysis indicated a significant reduction in the distal nerve cross-sectional area, an increase in the mean myelinated fiber density and an increase in the estimated total number of myelinated nerve fibers in both experimental groups. Mean fiber diameter and myelin sheath thickness had not fully returned to normal in either experimental group. Both the fiber size and myelin sheath thickness were significantly reduced in the cryoprobe group. In conclusion, the two lesion types have remarkably similar patterns of recovery. Functional data suggest that motor recovery precedes sensory recovery following a cryoprobe lesion.
本研究考察了与钳夹造成的神经挤压伤相比，冷冻（冷冻探针）损伤后前两个月内的行为、感觉、运动和结构恢复情况。在恢复的前两周内，两种损伤类型后的感觉和运动功能均完全丧失。趾展反射和坐骨神经运动行为功能指数恢复正常，两组间无显著差异。冷冻探针组疼痛退缩反射的潜伏期略短，但两组在第二个月均恢复至基线水平。冷冻探针组运动恢复表现出改善的再生模式，如通过指抽搐张力曲线的幅度所示。然而，各自的曲线面积并无差异。形态计量学分析表明，两个实验组的远端神经横截面积均显著减小，平均有髓纤维密度增加，估计有髓神经纤维总数增加。两个实验组的平均纤维直径和髓鞘厚度均未完全恢复正常。冷冻探针组的纤维大小和髓鞘厚度均显著减小。总之，两种损伤类型具有非常相似的恢复模式。功能数据表明，冷冻探针损伤后运动恢复先于感觉恢复。
