Department of Cranio- and Maxillofacial Surgery, Klinikum Bremen-Mitte, 28177 Bremen, Germany.
Int J Oral Maxillofac Surg. 2010 Sep;39(9):889-96. doi: 10.1016/j.ijom.2010.05.006. Epub 2010 Jul 1.
Bridging a nerve defect is sometimes necessary to achieve nerve regeneration after injury. Different methods and conduit designs have been considered, but only isograft transplants or prefabricated conduits are available. This study presents a comparison of prefabricated conduits and isograft transplants in rats, with the aim of making suggestions for clinical settings. In rats of inbred strains LEW and DA, a 1.5cm defect of the sciatic nerve was reconstructed by isograft (n=10) or conduit (n=10). Untreated rats (n=10), sham-operated rats (n=10) and nerves of the non-operated contralateral limb served as controls. Regeneration was evaluated by histomorphological examination and with walking track analysis of the ankle stance angle (ASA) and the sciatic functional index (SFI). After 16 weeks, myelinization and ASA in the conduit group were significantly superior to that in the isograft group. There was no significant difference in SFI between the groups. Reconstruction in the isograft group showed a negative impact on the non-operated side. Conduits and isografts did not reach the morphological or functional levels of untreated or sham-operated animals. The results suggest preferential conduits should be used for nerve reconstruction.
神经缺损的桥接有时是必需的,以实现损伤后的神经再生。已经考虑了不同的方法和导管设计,但只有同种异体移植或预制导管可用。本研究比较了大鼠预制导管和同种异体移植,旨在为临床环境提供建议。在近交系 LEW 和 DA 大鼠中,通过同种异体移植(n=10)或导管(n=10)重建 1.5cm 的坐骨神经缺损。未治疗的大鼠(n=10)、假手术大鼠(n=10)和未手术对侧肢体的神经作为对照。通过组织形态学检查和踝关节站立角度(ASA)和坐骨神经功能指数(SFI)的步行轨迹分析来评估再生。16 周后,导管组的髓鞘形成和 ASA 明显优于同种异体移植组。组间 SFI 无显著差异。同种异体移植组的重建对未手术侧有负面影响。导管和同种异体移植物均未达到未治疗或假手术动物的形态或功能水平。结果表明,应优先使用导管进行神经重建。