Moges Helina, Wu Xingjia, McCoy Jennifer, Vasconcelos Olavo M, Bryant Howard, Grunberg Neil E, Anders Juanita J
Department of Anatomy, Physiology and Genetics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
Lasers Surg Med. 2011 Nov;43(9):901-6. doi: 10.1002/lsm.21117.
Destruction of large segments of peripheral nerves results in chronic loss of sensation and paralysis. For this type of severe injury, the defect can be bridged by nerve grafts. However, even with state-of-the-art microsurgical techniques, there is minimal recovery of sensation and motor function. Light therapy (LT) has been shown to improve functional outcome after surgical intervention to repair injured nerves using different techniques. Our objective was to investigate the effect of LT on peripheral nerve regeneration and function after severe median nerve injury and microsurgical autologous nerve graft repair using fibrin glue.
STUDY DESIGN/MATERIALS AND METHODS: Adult female Sprague Dawley rats were used for this study. A 6-7 mm segment of the median nerve was excised and sural nerve segments from the same animal were used to bridge the gap using fibrin-based sealant. There were three experimental groups: control, autograft (AG), and autograft + LT (AG + LT). The AG + LT group received LT at the surgery site for 14 consecutive days using an 810 nm wavelength diode laser. Functional recovery was assessed bi-weekly by the grip strength test. Compound muscle action potential (CMAP) measurements were taken pre-injury and at 16 weeks post-surgery. Optical density measurement of S-100 immunoreactivity was done on the transplanted segment of the nerve.
The AG + LT group had faster functional recovery of grip strength (P < 0.05), shorter CMAP latency (P < 0.05), and higher S-100 immunoreactivity (P = 0.0213) when compared to the AG group. However, at 15 weeks, grip strength in both the AG and AG + LT groups, while significantly improved, were still below control levels.
These results suggest that LT can accelerate functional recovery and improve the quality of nerve regeneration after autograft repair of severely injured peripheral nerves.
周围神经的大片段损伤会导致慢性感觉丧失和瘫痪。对于这类严重损伤，可通过神经移植来桥接缺损。然而，即便采用最先进的显微外科技术，感觉和运动功能的恢复也微乎其微。光疗法（LT）已被证明可改善采用不同技术修复受损神经的手术干预后的功能结局。我们的目的是研究光疗法对严重正中神经损伤及使用纤维蛋白胶进行显微外科自体神经移植修复后周围神经再生和功能的影响。
研究设计/材料与方法：本研究使用成年雌性斯普拉格 - 道利大鼠。切除6 - 7毫米的正中神经段，并用同一动物的腓肠神经段借助纤维蛋白基密封剂桥接间隙。有三个实验组：对照组、自体移植组（AG）和自体移植 + 光疗法组（AG + LT）。AG + LT组在手术部位连续14天使用波长810纳米的二极管激光进行光疗法。每两周通过握力测试评估功能恢复情况。在损伤前和手术后16周进行复合肌肉动作电位（CMAP）测量。对神经移植段进行S - 100免疫反应性的光密度测量。
与AG组相比，AG + LT组握力功能恢复更快（P < 0.05），CMAP潜伏期更短（P < 0.05），S - 100免疫反应性更高（P = 0.0213）。然而，在15周时，AG组和AG + LT组的握力虽有显著改善，但仍低于对照组水平。
这些结果表明，光疗法可加速严重损伤的周围神经自体移植修复后的功能恢复并改善神经再生质量。
