Deslivia Maria Florencia, Lee Hyun-Joo, Adikrishna Arnold, Jeon In-Ho
Interaction and Robotics Research Center, Korea Institute of Science and Technology, Seoul, Korea.
Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
J Reconstr Microsurg. 2015 Nov;31(9):660-7. doi: 10.1055/s-0035-1558463. Epub 2015 Aug 17.
This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons.
Literature research was performed using the PubMed/MEDLINE database for English language studies with the keywords "decellularized nerve" and "processed nerve allograft." Inclusion criteria were prospective and retrospective case reviews in clinical settings. Exclusion criteria were case reports and case series.
We retrieved six level VIII studies and one level VI study (classified according to the Jovell and Navarro-Rubio scale) with a total of 131 reconstructions. The basic data ranges of the studies were as follows: patient age, 18 to 86 years; duration between initial injury and nerve reconstruction procedure, 8 hours to 4 years; and follow-up period, 40 days to 2 years. The maximum lengths of the nerve gap for chemically washed decellularized nerves and cryopreserved decellularized nerves were 50 and 100 mm, respectively. Quantitatively, the functional outcome ranges were as follows: static two-point discrimination, 3 to 5 mm; and moving two-point discrimination, 2 to 15 mm. For motor assessment, all patients had a > M3 Medical Research Council score. It is also important to notice that a large variability occurs in almost every factor in the reviewed studies.
Our study is the first to summarize the clinical results of decellularized nerves. Decellularized nerves have been used to bridge nerve gaps ranging from 5 to 100 mm with associated satisfactory outcomes in static and moving two-point discriminations.
这是一项系统评价，旨在评估临床应用去细胞神经后功能结局的证据。去细胞神经是同种异体移植物，其抗原成分已被去除，仅留下促进轴突完全再生的支架。
使用PubMed/MEDLINE数据库进行文献研究，检索英文研究，关键词为“去细胞神经”和“处理过的神经同种异体移植物”。纳入标准为临床环境中的前瞻性和回顾性病例综述。排除标准为病例报告和病例系列。
我们检索到6项VIII级研究和1项VI级研究（根据Jovell和Navarro-Rubio量表分类），共131例重建手术。这些研究的基本数据范围如下：患者年龄18至86岁；初次损伤至神经重建手术的时间为8小时至4年；随访期为40天至2年。化学清洗去细胞神经和冷冻保存去细胞神经的最大神经缺损长度分别为50和100毫米。在功能结局方面，定量范围如下：静态两点辨别觉为3至5毫米；动态两点辨别觉为2至15毫米。对于运动评估，所有患者的医学研究委员会评分均> M3。还需要注意的是，在所审查的研究中，几乎每个因素都存在很大差异。
我们的研究首次总结了去细胞神经的临床结果。去细胞神经已被用于桥接5至100毫米的神经缺损，在静态和动态两点辨别觉方面取得了令人满意的结果。
