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脊髓假体中的周围神经移植物在脊髓切除术后可实现再生并产生运动诱发电位。

Peripheral nerve grafts in a spinal cord prosthesis result in regeneration and motor evoked potentials following spinal cord resection.

作者信息

Nordblom Jonathan, Persson Jonas K E, Svensson Mikael, Mattsson Per

机构信息

Department of Clinical Neuroscience, Division of Clinical CNS Research, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.

出版信息

Restor Neurol Neurosci. 2009;27(4):285-95. doi: 10.3233/RNN-2009-0478.

Abstract

PURPOSE

To evaluate whether a standardized nerve graft bridging of a spinal cord injury gap in a device with white to grey matter projections allows regeneration and electrophysiological contact from supraspinal centers to the leg, since previous studies using nerve grafts in combination with acidic fibroblast growth factor have been difficult to microsurgically reproduce.

METHODS

A moulded prosthesis containing twelve peripheral nerve grafts with estimated pre-set projections guiding white tracts to grey matter replaced a spinal cord resection gap at level T11 in adult rats. The animals were evaluated with electrophysiology, morphology, immunohistochemistry and functional scoring.

RESULTS

At six months postoperatively the grafts were found to be positioned at the desired locations, motor evoked potentials were detected in 80% of the animals subjected to nerve graft bridging. Morphology and immunohistochemical analysis revealed numerous de novo axons in the grafts, which possibly reached into the spinal cord on the other side.

CONCLUSION

Replacing the resected spinal cord with oblique peripheral nerve grafts results in spinal cord regeneration and positive motor evoked potential. Transplantation of nerve grafts organized in a prosthesis is re-producible, sustains desired projections and ensures transverse ends towards the spinal cord surface and may be useful in the future.

摘要

目的

评估在具有白质到灰质投射的装置中,标准化神经移植桥接脊髓损伤间隙是否能实现从脊髓上中枢到腿部的再生和电生理连接,因为此前将神经移植与酸性成纤维细胞生长因子结合使用的研究难以通过显微手术重现。

方法

一个含有十二根周围神经移植物的模制假体,其预设投射估计可引导白质束至灰质,替代成年大鼠T11水平的脊髓切除间隙。对动物进行电生理、形态学、免疫组织化学和功能评分评估。

结果

术后六个月,发现移植物位于预期位置,在接受神经移植桥接的动物中,80%检测到运动诱发电位。形态学和免疫组织化学分析显示移植物中有大量新生轴突,这些轴突可能延伸至另一侧脊髓。

结论

用倾斜的周围神经移植物替代切除的脊髓可导致脊髓再生和阳性运动诱发电位。组织在假体中的神经移植可重现,维持预期投射,并确保朝向脊髓表面的横向末端,未来可能会有用。

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