Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey.
Department of Physiology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey.
J Invest Surg. 2021 Jul;34(7):773-783. doi: 10.1080/08941939.2019.1691686. Epub 2020 Feb 4.
Biologic reconstruction using tumor-bearing bone autografts devitalized by liquid nitrogen or extracorporeal irradiation (oncological sterilization) is a safe and effective method in musculoskeletal surgery. The purpose of this study was to examine the effects of these two oncological sterilization methods on nerve recovery.
A total of 48 rats were randomly divided into 3 groups as autograft, irradiation and liquid nitrogen groups. A nerve defect created in the right sciatic nerve was reconstructed with an autograft obtained from the nerve itself. Group I underwent reconstruction with standard nerve autograft. Group II and Group III underwent reconstruction with devitalized nerve autograft treated through extracorporeal irradiation and liquid nitrogen, respectively. The left sciatic nerves of the rats served as control. Electromyography, motor function test and histomorphological analysis were performed to assess the nerve recovery on the 3rd (early stage) and 4th months (late stage).
Electrophysiological assessment revealed better results in irradiation group compared with liquid nitrogen group in terms of myelinization and axonal regeneration. Motor performance of the autograft group was slightly better than the other groups. Histologically, autograft group demonstrated better results compared with other groups. Late-stage assessments revealed high rates of myelinization in the graft segment in liquid nitrogen group and in the segment distal to the graft in irradiation group.
This study has demonstrated that nerve autografts treated by oncological sterilization methods may be used for nerve reconstruction in limb salvage surgery. However, further studies are needed to clarify the applicability of these methods.
使用液氮或体外照射（肿瘤灭活）处理的带瘤骨自体移植物进行生物重建是肌肉骨骼外科中一种安全有效的方法。本研究旨在研究这两种肿瘤灭活方法对神经恢复的影响。
将 48 只大鼠随机分为自体骨组、照射组和液氮组 3 组。通过自体神经获得的移植物重建右侧坐骨神经缺损。第 I 组采用标准神经自体移植重建。第 II 组和第 III 组分别采用体外照射和液氮处理的失活神经自体移植进行重建。大鼠的左侧坐骨神经作为对照。在第 3 个月（早期）和第 4 个月（晚期）进行肌电图、运动功能测试和组织形态学分析，以评估神经恢复情况。
电生理评估显示，与液氮组相比，照射组在髓鞘形成和轴突再生方面的结果更好。自体骨组的运动功能略优于其他组。组织学上，自体骨组的结果优于其他组。晚期评估显示，液氮组移植物段和照射组移植物段远端的髓鞘化率较高。
本研究表明，经肿瘤灭活方法处理的神经自体移植物可用于肢体保肢手术中的神经重建。然而，需要进一步的研究来阐明这些方法的适用性。
