Vanhees Matthias, Chikenji Takako, Thoreson Andrew R, Zhao Chunfeng, Schmelzer James D, Low Philip A, An Kai-Nan, Amadio Peter C
Biomechanics Laboratory, Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905 USA.
Department of Neurology, Mayo Clinic, Rochester, MN USA.
Hand (N Y). 2013 Mar;8(1):54-9. doi: 10.1007/s11552-012-9469-2.
The most prominent nonneurological finding in the common compression neuropathy carpal tunnel syndrome (CTS) is fibrosis of the subsynovial connective tissue (SSCT). Recently, a rabbit model of CTS has been developed, based on the hypothesis that SSCT injury and subsequent fibrosis cause nerve compression. The purpose of this study was to evaluate the effects in this model at earlier and later time points than have heretofore been reported.
Sixty rabbits were operated on and observed at two different time periods: 6 and 24 weeks. Nerve electrophysiology (EP), SSCT histology, and SSCT mechanical properties were assessed.
There was no significant difference in median motor nerve amplitude or latency at either time point. The total cell density in the SSCT was significantly higher at 6 and 24 weeks compared to controls. The mean size of the collagen fibrils in the SSCT was higher 6 and 24 weeks after surgery compared to controls. Both the ultimate load and the total energy absorption of the SSCT were significantly higher at 6 and 24 weeks compared to controls.
In this model, there were signs of SSCT fibrosis and histology changes at 6 weeks, which persist after 24 weeks. Thus, this model leads to sustained SSCT fibrosis, which is one characteristic of human CTS. However, no significant EP changes were found at these two time points, which is in contrast to the findings reported previously for this model at 12 weeks. The significance of the differences in EP findings will be the subject of future studies.
在常见的压迫性神经病变——腕管综合征（CTS）中，最显著的非神经学表现是滑膜下结缔组织（SSCT）纤维化。最近，基于SSCT损伤及随后的纤维化导致神经受压这一假说，建立了一种CTS兔模型。本研究的目的是在比以往报道更早和更晚的时间点评估该模型中的效应。
对60只兔子进行手术，并在两个不同时间段进行观察：6周和24周。评估神经电生理学（EP）、SSCT组织学和SSCT力学性能。
在两个时间点，正中运动神经振幅或潜伏期均无显著差异。与对照组相比，6周和24周时SSCT中的总细胞密度显著更高。与对照组相比，术后6周和24周时SSCT中胶原纤维的平均尺寸更大。与对照组相比，6周和24周时SSCT的极限负荷和总能量吸收均显著更高。
在该模型中，6周时出现SSCT纤维化和组织学改变的迹象，并在24周后持续存在。因此，该模型导致持续的SSCT纤维化，这是人类CTS的一个特征。然而，在这两个时间点未发现显著的EP变化，这与之前该模型在12周时的报道结果相反。EP结果差异的意义将是未来研究的主题。
