Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria.
Center for Biomedical Research, Medical University of Vienna, Vienna, Austria.
Elife. 2021 Oct 1;10:e71312. doi: 10.7554/eLife.71312.
Surgical nerve transfers are used to efficiently treat peripheral nerve injuries, neuromas, phantom limb pain, or improve bionic prosthetic control. Commonly, one donor nerve is transferred to one target muscle. However, the transfer of multiple nerves onto a single target muscle may increase the number of muscle signals for myoelectric prosthetic control and facilitate the treatment of multiple neuromas. Currently, no experimental models are available. This study describes a novel experimental model to investigate the neurophysiological effects of peripheral double nerve transfers to a common target muscle. In 62 male Sprague-Dawley rats, the ulnar nerve of the antebrachium alone (n=30) or together with the anterior interosseus nerve (n=32) was transferred to reinnervate the long head of the biceps brachii. Before neurotization, the motor branch to the biceps' long head was transected at the motor entry point. Twelve weeks after surgery, muscle response to neurotomy, behavioral testing, retrograde labeling, and structural analyses were performed to assess reinnervation. These analyses indicated that all nerves successfully reinnervated the target muscle. No aberrant reinnervation was observed by the originally innervating nerve. Our observations suggest a minimal burden for the animal with no signs of functional deficit in daily activities or auto-mutilation in both procedures. Furthermore, standard neurophysiological analyses for nerve and muscle regeneration were applicable. This newly developed nerve transfer model allows for the reliable and standardized investigation of neural and functional changes following the transfer of multiple donor nerves to one target muscle.
外科神经转移术用于有效治疗周围神经损伤、神经瘤、幻肢痛或改善仿生假肢控制。通常，一根供体神经转移到一根靶肌肉。然而，将多条神经转移到单个靶肌肉上可能会增加肌电假肢控制的肌肉信号数量，并有助于治疗多个神经瘤。目前，尚无实验模型可用。本研究描述了一种新的实验模型，用于研究外周双神经转移到共同靶肌肉的神经生理效应。在 62 只雄性 Sprague-Dawley 大鼠中，单独在前臂的尺神经（n=30）或与骨间前神经（n=32）一起转移以重新支配肱二头肌长头。在神经化之前，在运动入口处切断长头肱二头肌的运动支。手术后 12 周，进行神经切开术的肌肉反应、行为测试、逆行标记和结构分析，以评估再支配。这些分析表明所有神经都成功地重新支配了靶肌肉。没有观察到原本支配神经的异常再支配。我们的观察表明，动物的负担最小，在两种手术中均没有出现日常活动功能缺陷或自残的迹象。此外，适用于神经和肌肉再生的标准神经生理分析。这种新开发的神经转移模型允许可靠和标准化地研究多个供体神经转移到单个靶肌肉后的神经和功能变化。
