使用新型实验装置通过牵张神经再生成功修复神经缺损
Successful Reconstruction of Nerve Defects Using Distraction Neurogenesis with a New Experimental Device.
作者信息
Yousef Mohamed Abdelhamid Ali, Dionigi Paolo, Marconi Stefania, Calligaro Alberto, Cornaglia Antonia Icaro, Alfonsi Enrico, Auricchio Ferdinando
机构信息
Experimental Surgery and Microsurgery Research Unit, Department of Clinical Surgical Science, Faculty of Medicine, University of Pavia, Pavia, Italy.
Department of General Surgery, Faculty of Medicine, University of Pavia, Pavia, Italy.
出版信息
Basic Clin Neurosci. 2015 Oct;6(4):253-64.
INTRODUCTION
Repair of peripheral nerve injuries is an intensive area of challenge and research in modern reconstructive microsurgery. Intensive research is being carried out to develop effective alternatives to the standard nerve autografting, avoiding its drawbacks. The aim of the study was to evaluate the effectiveness of a newly designed mechanical device for the reconstruction of the sciatic nerve in rats in comparison to nerve autografting and to assess the pain during the period of distraction neurogenesis.
METHODS
Fourteen Sprague Dawley rats were used and randomly assigned into 2 groups with 7 rats in each group; group A (Nerve Autografting group) in which a 10-mm segment of the sciatic nerve was resected and rotated 180 degrees, then primary end-to-end neurorrhaphy was performed in the reverse direction; group B (Nerve Lengthening group) in which the mechanical device was inserted after surgical resection of 10 mm of the sciatic nerve, then secondary end-to-end neurorrhaphy was performed after completing the nerve lengthening. Thirteen weeks later, assessment of the functional sciatic nerve recovery using static sciatic index (SSI) was performed. Furthermore, fourteen weeks after the nerve resection, assessment of the nerve regeneration with electrophysiological study and histological analysis were performed. Also, gastrocnemius wet weight was measured. For pain assessment in group B, Rat Grimace Scale (RGS) score was used.
RESULTS
Significantly better functional recovery rate (using the SSI) was reported in the nerve lengthening group in comparison to autografting group. Also, a statistically significant higher nerve conduction velocity was detected in the nerve lengthening group. On histological analysis of the distal nerve section at 3 mm distal to the nerve repair site, significant myelin sheath thickness was detected in the nerve lengthening group.
DISCUSSION
Distraction neurogenesis with the new experimental device is a reliable therapeutic method for the reconstruction of nerve defects.
引言
周围神经损伤的修复是现代重建显微外科中一个充满挑战且研究密集的领域。目前正在进行深入研究，以开发有效的标准神经自体移植替代方法，避免其缺点。本研究的目的是评估一种新设计的机械装置在大鼠坐骨神经重建中的有效性，并与神经自体移植进行比较，同时评估牵张神经再生期间的疼痛情况。
方法
使用14只Sprague Dawley大鼠，随机分为2组，每组7只；A组（神经自体移植组），切除10毫米的坐骨神经节段并旋转180度，然后反向进行一期端端神经缝合；B组（神经延长组），在手术切除10毫米坐骨神经后插入机械装置，在完成神经延长后进行二期端端神经缝合。13周后，使用静态坐骨神经指数（SSI）评估坐骨神经功能恢复情况。此外，在神经切除14周后，进行电生理研究和组织学分析以评估神经再生情况。同时测量腓肠肌湿重。对于B组的疼痛评估，使用大鼠面部表情量表（RGS）评分。
结果
与自体移植组相比，神经延长组的功能恢复率（使用SSI）显著更好。此外，在神经延长组中检测到统计学上显著更高的神经传导速度。在神经修复部位远端3毫米处的远端神经节段进行组织学分析时，在神经延长组中检测到显著的髓鞘厚度。
讨论
使用新实验装置进行牵张神经再生是一种可靠的治疗神经缺损的方法。
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