Ecole de Chirurgie de l'Assistance Publique des Hôpitaux de Paris, Paris, France.
Spinal Cord. 2010 May;48(5):367-74. doi: 10.1038/sc.2009.144. Epub 2009 Nov 24.
Experimental animal study.
To evaluate motor and sensitive axonal regrowth after multiple intercosto-lumbar neurotizations in a sheep model.
France.
Fifteen sheep were separated into three groups. Five sheep had multiple intercosto-lumbar neurotizations and a spinal cord lesion, five sheep were neurotized without any spinal cord lesion and five sheep had a spinal cord lesion without any neurotizations. Six months after the initial surgery, histological study of the neurotized roots was performed.
The length of the three rerouted intercostal nerves was sufficient in the 10 sheep to perform an intercosto-lumbar neurotization in good conditions. Eight sheep out of the 15 had postoperative complications responsible for the animal's death in five cases. Histological cross-sections of all the neurotized L2, L3 and L4 roots showed numerous myelinated regenerated axons. Dorsal root ganglions of neurotized roots showed both large and small neurons with normal nucleus and cytoplasm. The fluorescent retrograde labeling of 18 roots revealed labeled motor neurons in five cases.
This study demonstrates the technical feasibility of intercosto-lumbar neurotizations in a big mammalian model. Intercostal nerve harvesting and rerouting was successfully performed in all the cases. Our histological results proved, in all the animals studied, the ability of motor and sensitive neurons to regenerate through the neurotization area. In the context of the future clinical application of strategies aimed at promoting axonal regeneration after severe spinal cord injury, the present data suggest that multiple intercosto-lumbar neurotization could be helpful to promote lower limb muscular strength recovery after spinal cord injuries.
实验动物研究。
在绵羊模型中评估多次肋间脊神经吻合后运动和感觉轴突的再生情况。
法国。
将 15 只绵羊分为三组。5 只绵羊进行多次肋间脊神经吻合和脊髓损伤，5 只绵羊进行神经吻合而无脊髓损伤，5 只绵羊进行脊髓损伤而无神经吻合。初次手术后 6 个月，对吻合的神经根进行组织学研究。
在 10 只绵羊中，有 3 条再 routed 肋间神经的长度足以在良好的条件下进行肋间脊神经吻合。15 只绵羊中有 8 只出现术后并发症，导致 5 例动物死亡。所有吻合的 L2、L3 和 L4 神经根的组织学横切面均显示出大量有髓再生轴突。吻合根的背根神经节既有大神经元也有小神经元，细胞核和细胞质正常。18 条根的荧光逆行标记显示 5 例有标记的运动神经元。
本研究证明了在大型哺乳动物模型中进行肋间脊神经吻合的技术可行性。所有病例均成功进行了肋间神经采集和再 routing。我们的组织学结果证明，在所研究的所有动物中，运动和感觉神经元都有能力通过神经吻合区域再生。在未来旨在促进严重脊髓损伤后轴突再生的策略的临床应用背景下，本研究数据表明，多次肋间脊神经吻合可能有助于促进脊髓损伤后下肢肌肉力量的恢复。
