Mackinnon S E, Dellon A L
Division of Plastic Surgery and Neurosurgery, Johns Hopkins University, Baltimore, MD.
J Hand Surg Am. 1988 May;13(3):345-51. doi: 10.1016/s0363-5023(88)80006-6.
This study evaluates the effect of internal neurolysis on a chronically compressed primate median nerve as compared with a simple decompression procedure. In 11 adult, cynomologous monkeys, the median nerve in the carpal tunnel was banded with a silicone tube. After 6 months of nerve compression (mild to moderate compression in our model) in eight monkeys, a microneurosurgical internal neurolysis was carried out on the median nerve of one hand and a simple decompression (removal of band) was carried out on the median nerve of the other hand. Histologic, morphologic, and electrophysiologic evaluation was carried out 6 months later. Six control animals were similarly evaluated after 0, 6, and 12 months of nerve compression. The degree of compression produced was not severe in that it did not cause Wallerian degeneration. Histologic and electrophysiologic improvement was produced in both treatment groups over the two chronically compressed groups (6 and 12 months of compression). While internal neurolysis did not cause intraneural scarring or nerve fiber damage as compared with simple decompression alone, there was no difference noted between the effects of these two treatment methods on the chronically compressed nerve.
本研究评估了与单纯减压手术相比，内部神经松解术对长期受压的灵长类动物正中神经的影响。在11只成年食蟹猴中，用硅胶管绑扎腕管内的正中神经。8只猴子在神经受压6个月后（在我们的模型中为轻度至中度受压），对一只手的正中神经进行显微神经外科内部神经松解术，对另一只手的正中神经进行单纯减压（去除绑扎带）。6个月后进行组织学、形态学和电生理评估。6只对照动物在神经受压0、6和12个月后进行类似评估。所产生的压迫程度并不严重，未导致华勒氏变性。与两个长期受压组（受压6个月和12个月）相比，两个治疗组均出现了组织学和电生理改善。与单纯减压相比，内部神经松解术未引起神经内瘢痕形成或神经纤维损伤，但这两种治疗方法对长期受压神经的影响之间未观察到差异。
