Meng Depeng, Zhou Jun, Lin Yaofa, Xie Zheng, Chen Huihao, Yu Ronghua, Lin Haodong, Hou Chunlin
Department of Orthopedics, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, People's Republic of China.
Department of Orthopedics, the Second People's Hospital of Karamay, Karamay, Xinjiang Province, People's Republic of China.
Acta Neurochir (Wien). 2018 Jul;160(7):1385-1391. doi: 10.1007/s00701-018-3565-1. Epub 2018 May 28.
Quadriceps palsy is mainly caused by proximal lesions in the femoral nerve. The obturator nerve has been previously used to repair the femoral nerve, although only a few reports have described the procedure, and the outcomes have varied. In the present study, we aimed to confirm the feasibility and effectiveness of this treatment in a rodent model using the randomized control method.
Sixty Sprague-Dawley rats were randomized into two groups: the experimental group, wherein rats underwent femoral neurectomy and obturator nerve transfer to the femoral nerve motor branch; and the control group, wherein rats underwent femoral neurectomy without nerve transfer. Functional outcomes were measured using the BBB score, muscle mass, and histological assessment.
At 12 and 16 weeks postoperatively, the rats in the experimental group exhibited recovery to a stronger stretch force of the knee and higher BBB score, as compared to the control group (p < 0.05). The muscle mass and myofiber cross-sectional area of the quadriceps were heavier and larger than those in the control group (p < 0.05). A regenerated nerve with myelinated and unmyelinated fibers was observed in the experimental group. No significant differences were observed between groups at 8 weeks postoperatively (p > 0.05).
Obturator nerve transfer for repairing femoral nerve injury was feasible and effective in a rat model, and can hence be considered as an option for the treatment of femoral nerve injury.
股四头肌麻痹主要由股神经近端病变引起。闭孔神经此前已被用于修复股神经，尽管仅有少数报告描述了该手术过程，且结果各异。在本研究中，我们旨在使用随机对照方法在啮齿动物模型中证实这种治疗方法的可行性和有效性。
将60只Sprague-Dawley大鼠随机分为两组：实验组，大鼠接受股神经切除术并将闭孔神经转移至股神经运动支；对照组，大鼠接受股神经切除术但不进行神经转移。使用BBB评分、肌肉质量和组织学评估来测量功能结果。
术后12周和16周时，与对照组相比，实验组大鼠膝关节伸展力恢复更强，BBB评分更高（p < 0.05）。股四头肌的肌肉质量和肌纤维横截面积比对照组更重、更大（p < 0.05）。实验组观察到有髓和无髓纤维的再生神经。术后8周时两组之间未观察到显著差异（p > 0.05）。
在大鼠模型中，闭孔神经转移修复股神经损伤是可行且有效的，因此可被视为治疗股神经损伤的一种选择。
