Korsak Alina, Likhodiievskyi Volodymyr, Sokurenko Liudmyla, Chaikovsky Yuri
Department of Histology and Embriology, Natsional'nii Meditsnii Universitet Imeni O O Bogomoltsa, Kyiv, Ukraine.
J Neurol Surg A Cent Eur Neurosurg. 2018 Jul;79(4):291-295. doi: 10.1055/s-0037-1603633. Epub 2017 Jul 14.
Innovative surgical techniques form the basis of therapeutic approaches to address the negative consequences of nerve damage. This study evaluated the effectiveness of nerve trunk regeneration after the use of an electrosurgical instrument by looking at the patterns of morphological changes in the injured nerve and the structural elements of the segment motor center.
The study was performed on male Wistar rats divided into four groups: group 1, control; group 2, rats with simulated sciatic nerve injury with epineural sutures; 3, rats subjected to an experimental surgical procedure using high-frequency electric welding technology; and 4, rats with simulated sciatic nerve injury without posttransection repair. To study changes in the peripheral stump of the transected nerves and L5 segments of the spinal cord, we used histologic, immunohistochemical, and morphometric methods.
At week 12 after the surgery, there were more S-100+ Schwann cells, increased expression of neurofilaments (NFs), and glial fibrillary acidic protein in the peripheral stump in group 3 than in groups 2 and 4, which indicates enhanced neurotization and myelination. Group 3 animals demonstrated reduced expression of S-100 and NFs in the motor center of the spinal cord compared with group 2 that suggests less pronounced reactive changes caused by electric welding technology.
The study showed a novel surgical method using an electrosurgical instrument in a welding mode to stimulate regeneration of the injured nerve and to cause less prominent reactive changes in its segment motor center.
创新的外科技术构成了应对神经损伤负面后果的治疗方法的基础。本研究通过观察受损神经的形态变化模式和节段运动中心的结构要素,评估了使用电外科器械后神经干再生的有效性。
本研究在雄性Wistar大鼠上进行,分为四组:第1组为对照组;第2组为用神经外膜缝合模拟坐骨神经损伤的大鼠;第3组为采用高频电焊技术进行实验性手术操作的大鼠;第4组为模拟坐骨神经损伤但未进行横断后修复的大鼠。为了研究横断神经的外周残端和脊髓L5节段的变化,我们使用了组织学、免疫组织化学和形态计量学方法。
术后12周,第3组外周残端中S-100+雪旺细胞更多,神经丝(NFs)和胶质纤维酸性蛋白的表达增加,这表明第3组的神经化和髓鞘形成增强,相比之下,第2组和第4组则不然。与第2组相比,第3组动物脊髓运动中心的S-100和NFs表达降低,这表明电焊技术引起的反应性变化不太明显。
该研究显示了一种新颖的手术方法,即使用处于焊接模式的电外科器械来刺激受损神经的再生,并在其节段运动中心引起不太明显的反应性变化。