Department of Orthopedic Surgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address for A.Y. Shin:
J Bone Joint Surg Am. 2013 Nov 6;95(21):1952-8. doi: 10.2106/JBJS.M.00215.
The purpose of this study was to evaluate the motor nerve recovery in a rabbit model after repair of a 3-cm gap in the peroneal nerve with a conduit filled with a collagen-GAG (glycosaminoglycan) matrix and compare the results with those after reconstruction with an autograft or an empty collagen conduit.
Forty-two male New Zealand rabbits were divided into three experimental groups. In each group, a unilateral 3-cm peroneal nerve defect was repaired with a nerve autograft, an empty collagen conduit, or a conduit filled with a collagen-GAG matrix. At six months, nerve regeneration was evaluated on the basis of the compound muscle action potentials, maximum isometric tetanic force, and wet muscle weight of the tibialis anterior muscle as well as nerve histomorphometry.
The autograft group had significantly better motor recovery than the conduit groups. The empty collagen conduits and conduits filled with the collagen-GAG matrix led to results that were similar to each other.
On the basis of this rabbit model, autologous nerve grafting remains the gold standard in the reconstruction of 3-cm segmental motor nerve defects.
Segmental motor nerve defects should be reconstructed with autograft nerves. The use of a collagen conduit filled with a collagen-GAG matrix for motor nerve reconstruction should be limited until additional animal studies are performed.
本研究旨在评估在兔模型中修复 3cm 腓神经缺损时，使用填充胶原-GAG（糖胺聚糖）基质的导管与使用自体移植物或空胶原导管进行修复后的运动神经恢复情况，并比较结果。
将 42 只雄性新西兰兔分为三组实验。在每组中，通过神经自体移植物、空胶原导管或填充胶原-GAG 基质的导管修复单侧 3cm 腓神经缺损。在 6 个月时，根据复合肌肉动作电位、最大等长强直收缩力和比目鱼肌湿重以及神经组织形态计量学评估神经再生情况。
自体移植物组的运动恢复明显优于导管组。空胶原导管和填充胶原-GAG 基质的导管导致的结果相似。
基于本兔模型，自体神经移植仍然是重建 3cm 节段性运动神经缺损的金标准。
应使用自体神经移植物重建节段性运动神经缺损。在进行更多的动物研究之前，应限制使用填充胶原-GAG 基质的胶原导管进行运动神经重建。
