Department of Trauma and Orthopedics, Peking University People's Hospital 11th Xizhimen South Street, Beijing, China.
Am J Transl Res. 2015 Jan 15;7(1):53-65. eCollection 2015.
Functional recovery is often unsatisfactory after lesions in the peripheral nervous system despite the strong potential for regeneration and advances in microsurgical techniques. Axonal regeneration in mixed nerve into inappropriate pathways is a major contributing factor to this failure. In this study, the rat femoral nerve model of transection and surgical repair was used to evaluate the specificity of motor axon regeneration as well as functional and morphological recovery using biodegradable conduit small gap tubulization compared to epineurial neurorrhaphy. 12 weeks after nerve repair, the specificity was assessed using the retrograde neurotracers TB and DiI to backlabel motor neurons that regenerate axons into muscle and cutaneous pathways. To evaluate the functional recovery of the quadriceps muscle, the quadriceps muscle forces were examined. The quadriceps muscle and myelinated axons were assessed using electrophysiology and histology. The results showed that the specificity of motor axon regeneration (preferential reinnervation) was significantly higher when the nerve transection was treated by biodegradable conduit small gap tubulization and there was no significant difference between the two suture methods with respect to the functional and morphological recovery. This study demonstrated that the quicker and easier biodegradable conduit small gap tubulization may get more accurate reinnervation than traditional epineurial neurorrhaphy and produced functional and morphological recovery equal to traditional epineurial neurorrhaphy.
尽管周围神经系统损伤后具有很强的再生潜力和显微外科技术的进步,但功能恢复往往仍不令人满意。混合神经中的轴突再生进入不适当的途径是导致这种失败的一个主要因素。在这项研究中,使用大鼠股神经横断和手术修复模型来评估使用可生物降解导管小间隙管化与神经外膜神经吻合术相比,运动轴突再生的特异性以及功能和形态恢复。在神经修复后 12 周,使用逆行示踪剂 TB 和 DiI 评估运动神经元的特异性,这些神经元的轴突再生到肌肉和皮肤途径。为了评估股四头肌的功能恢复,检查股四头肌的肌力。使用电生理学和组织学评估股四头肌和有髓轴突。结果表明,当使用可生物降解导管小间隙管化治疗神经横断时,运动轴突再生的特异性(优先再支配)明显更高,而两种缝合方法在功能和形态恢复方面没有显著差异。这项研究表明,与传统的神经外膜神经吻合术相比,更快、更容易的可生物降解导管小间隙管化可能获得更准确的再支配,并产生与传统的神经外膜神经吻合术相当的功能和形态恢复。