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两种胶原神经导管与自体神经移植的比较:大鼠运动神经再生模型

A Comparison Between Two Collagen Nerve Conduits and Nerve Autograft: A Rat Model of Motor Nerve Regeneration.

作者信息

Saltzman Eliana B, Villa Jordan C, Doty Stephen B, Feinberg Joseph H, Lee Steve K, Wolfe Scott W

机构信息

Center for Brachial Plexus and Traumatic Nerve Injury, Hospital for Special Surgery, New York, NY.

Hospital for Special Surgery, Mineralized Tissue Laboratory, New York, NY.

出版信息

J Hand Surg Am. 2019 Aug;44(8):700.e1-700.e9. doi: 10.1016/j.jhsa.2018.10.008. Epub 2018 Nov 27.

Abstract

PURPOSE

To compare recovery in a rat model of sciatic nerve injury using a novel polyglycolic acid (PGA) conduit, which contains collagen fibers within the tube, as compared with both a hollow collagen conduit and nerve autograft. We hypothesize that a conduit with a scaffold will provide improved nerve regeneration over hollow conduits and demonstrate no significant differences when compared with autograft.

METHODS

A total of 72 Sprague-Dawley rats were randomized into 3 experimental groups, in which a unilateral 10-mm sciatic defect was repaired using either nerve autograft, a hollow collagen conduit, or a PGA collagen-filled conduit. Outcomes were measured at 12 and 16 weeks after surgery, and included bilateral tibialis anterior muscle weight, voltage and force maximal contractility, assessment of ankle contracture, and nerve histology.

RESULTS

In all groups, outcomes improved between 12 and 16 weeks. On average, the autograft group outperformed both conduit groups, and the hollow conduit demonstrated improved outcomes when compared with the PGA collagen-filled conduit. Differences in contractile force, however, were significant only at 12 weeks (autograft > hollow collagen conduit > PGA collagen-filled conduit). At 16 weeks, contractile force demonstrated no significant difference but corroborated the same absolute results (autograft > hollow collagen conduit > PGA collagen-filled conduit).

CONCLUSIONS

Nerve repair using autograft provided superior motor nerve recovery over the 2 conduits for a 10-mm nerve gap in a murine acute transection injury model. The hollow collagen conduit demonstrated superior results when compared with the PGA collagen-filled conduit.

CLINICAL RELEVANCE

The use of a hollow collagen conduit provides superior motor nerve recovery as compared with a PGA collagen-filled conduit.

摘要

目的

在大鼠坐骨神经损伤模型中,比较一种新型聚乙醇酸(PGA)导管(管内含有胶原纤维)与中空胶原导管及自体神经移植的恢复情况。我们假设带支架的导管能比中空导管更好地促进神经再生,且与自体移植相比无显著差异。

方法

总共72只Sprague-Dawley大鼠被随机分为3个实验组,分别用自体神经移植、中空胶原导管或填充胶原的PGA导管修复单侧10毫米的坐骨神经缺损。在术后12周和16周测量结果,包括双侧胫前肌重量、电压和最大收缩力、踝关节挛缩评估以及神经组织学检查。

结果

在所有组中,12周和16周之间结果均有改善。平均而言,自体移植组的表现优于两个导管组,与填充胶原的PGA导管相比,中空导管的结果有所改善。然而,收缩力的差异仅在12周时显著(自体移植>中空胶原导管>填充胶原的PGA导管)。在16周时,收缩力无显著差异,但证实了相同的绝对结果(自体移植>中空胶原导管>填充胶原的PGA导管)。

结论

在小鼠急性横断损伤模型中,对于10毫米的神经间隙,使用自体移植进行神经修复比两种导管能提供更好的运动神经恢复。与填充胶原的PGA导管相比,中空胶原导管显示出更好的结果。

临床意义

与填充胶原的PGA导管相比,使用中空胶原导管能提供更好的运动神经恢复。

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