Lubiatowski Przemyslaw, Unsal Faik M, Nair Dileep, Ozer Kagan, Siemionow Maria
Department of Plastic Surgery, The Cleveland Clinic, Cleveland, OH 44195, USA.
Microsurgery. 2008;28(3):160-7. doi: 10.1002/micr.20472.
The purpose of the study was evaluation of nerve recovery following epineural sleeve technique for graft reconstruction in rat sciatic nerve. This technique provides the epineural sleeve to cover and separate the site of coaptation. Animals were divided into three groups: CNG-conventional nerve grafting, ESN-epineural sleeve from recipient nerve stumps, ESG-epineural sleeve from graft. Nerve regeneration was evaluated by pin-prick, toe-spread test, walking track analysis and somatosensory-evoked potentials (SEP), gastrocnemius index (GI), and histomorphometric evaluation. Most parameters (SFI, SEPs, and GI) showed significantly better nerve recovery for ESN group when compared to conventional CNG group. Also ESG group revealed better result for SFI. Better functional results for ESN and ESG groups were further confirmed by histomorphometric analysis: higher axon density and diameters as well as thicker myelin sheath. Epineural sleeve graft technique may be promising method with potential application for nerve reconstructive procedures. Better functional nerve recovery can be anticipated.
本研究的目的是评估大鼠坐骨神经移植重建中采用神经外膜套管技术后的神经恢复情况。该技术提供神经外膜套管以覆盖和分隔吻合部位。动物被分为三组:CNG-传统神经移植组、ESN-取自受体神经残端的神经外膜套管组、ESG-取自移植体的神经外膜套管组。通过针刺、趾展试验、行走轨迹分析和体感诱发电位(SEP)、腓肠肌指数(GI)以及组织形态计量学评估来评价神经再生情况。与传统的CNG组相比,大多数参数(SFI、SEP和GI)显示ESN组的神经恢复明显更好。ESG组的SFI结果也更好。ESN组和ESG组更好的功能结果通过组织形态计量学分析得到进一步证实:轴突密度和直径更高,髓鞘更厚。神经外膜套管移植技术可能是一种有前景的方法,具有在神经重建手术中潜在应用的价值。可以预期会有更好的功能性神经恢复。