Vleggeert-Lankamp Carmen L A M
Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands.
J Neurosurg. 2007 Dec;107(6):1168-89. doi: 10.3171/JNS-07/12/1168.
A number of evaluation methods that are currently used to compare peripheral nerve regeneration with alternative repair methods and to judge the outcome of a new paradigm were hypothesized to lack resolving power. This would too often lead to the conclusion that the outcome of a new paradigm could not be discerned from the outcome of the current gold standard, the autograft. As a consequence, the new paradigm would incorrectly be judged as successful.
An overview of the methods that were used to evaluate peripheral nerve regeneration after grafting of the rat sciatic nerve was prepared. All articles that were published between January 1975 and December 2004 and concerned grafting of the rat sciatic nerve (minimum graft length 5 mm) and in which the experimental method was compared with an untreated or another grafted nerve were included. The author scored the presence of statistically significant differences between paradigms.
Evaluation of nerve fiber count, nerve fiber density, N-ratio, nerve histological success ratio, compound muscle action potential, muscle weight, and muscle tetanic force are methods that were demonstrated to have resolving power.
A number of evaluation methods are not suitable to demonstrate a significant difference between experimental paradigms in peripheral nerve regeneration. It is preferable to apply a combination of evaluation methods with resolving power to evaluate nerve regeneration properly.
目前用于比较周围神经再生与其他修复方法以及判断新方法效果的多种评估方法被认为缺乏分辨能力。这常常会导致得出这样的结论：新方法的效果无法与当前的金标准——自体移植的效果区分开来。因此，新方法会被错误地判定为成功。
对用于评估大鼠坐骨神经移植后周围神经再生的方法进行了综述。纳入了1975年1月至2004年12月期间发表的所有涉及大鼠坐骨神经移植（最小移植长度5毫米）且将实验方法与未处理的或另一移植神经进行比较的文章。作者对不同方法之间是否存在统计学显著差异进行了评分。
对神经纤维计数、神经纤维密度、N比率、神经组织学成功率、复合肌肉动作电位、肌肉重量和肌肉强直力的评估方法被证明具有分辨能力。
多种评估方法不适用于证明周围神经再生实验方法之间的显著差异。最好应用具有分辨能力的评估方法组合来正确评估神经再生。
