Singh Suyash, Srivastava Arun Kumar, Baranwal Atul K, Bhatnagar Ankur, Das Kuntal Kanti, Jaiswal Sushila, Behari Sanjay
Department of Neurosurgery, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, India.
Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Neurol India. 2021 Mar-Apr;69(2):318-325. doi: 10.4103/0028-3886.314576.
A lot of options have been tried for bridging the two ends of the injured nerves. Researchers have used decellularized nerve grafts, artificial materials and even nerve growth factors to augment functional recovery. These materials are either costly or inaccessible in developing world.
The study aimed to evaluate the efficacy of the silicone conduit in a rat sciatic nerve injury model.
24 healthy Sprague-Dawley (SD) rats (250-300 grams; 8-10 weeks) were used and right sciatic nerve was exposed; transected and re-anastomosed by two different methods in 16 rats. In control group, n = 8 (Group I) the sciatic nerve was untouched; Group II (reverse nerve anastomosis, n = 8): 1-centimeter of nerve was cut and re-anastomosed by using 10-0 monofilament suture; Group III (silicone conduit, n = 8) 1-centimeter nerve segment was cut, replaced by silicone conduit and supplemented by fibrin glue]. Evaluation of nerve recovery was done functionally (pain threshold and sciatic functional index) over 3 months and histologically and electron microscopically.
Functional results showed a trend of clinical improvement in Group III and II but recovery was poor and never reached up to normal. Histopathological and electron microscopic results showed an incomplete axonal regeneration in Groups II and III. Psychological analyses showed that no outwards signs of stress were present and none of the rats showed paw biting and teeth chattering.
The silicone conduit graft may be an economical and effective alternative to presently available interposition grafts, however for short segments only.
为了连接受损神经的两端，人们尝试了许多方法。研究人员使用了脱细胞神经移植物、人工材料甚至神经生长因子来促进功能恢复。这些材料要么成本高昂，要么在发展中国家难以获得。
本研究旨在评估硅胶导管在大鼠坐骨神经损伤模型中的疗效。
选用24只健康的Sprague-Dawley（SD）大鼠（体重250-300克；8-10周龄），暴露右侧坐骨神经；16只大鼠通过两种不同方法将其切断并重新吻合。对照组，n = 8（第一组）坐骨神经未处理；第二组（反向神经吻合，n = 8）：切断1厘米神经，用10-0单丝缝线重新吻合；第三组（硅胶导管，n = 8）切断1厘米神经段，用硅胶导管替代，并用纤维蛋白胶补充]。在3个月内通过功能（疼痛阈值和坐骨神经功能指数）、组织学和电子显微镜评估神经恢复情况。
功能结果显示第三组和第二组有临床改善趋势，但恢复较差，从未达到正常水平。组织病理学和电子显微镜结果显示第二组和第三组轴突再生不完全。心理分析表明没有应激的外在迹象，没有大鼠出现咬爪和磨牙现象。
硅胶导管移植物可能是目前可用的插入移植物的一种经济有效的替代方法，但仅适用于短节段。
