Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, New Jersey, USA.
Neurosurgery. 2023 May 1;92(5):1091-1098. doi: 10.1227/neu.0000000000002324. Epub 2023 Jan 3.
We have developed a novel reinnervation technique called nerve-muscle-endplate grafting in the native motor zone (NMEG-NMZ). However, it remains unknown whether the NMEG-NMZ is effective for limb reinnervation.
To evaluate the efficacy of the NMEG-NMZ in limb muscle reinnervation.
Forty-five adult rats were divided into 3 groups: NMEG, end-to-end anastomosis (EEA, technique control), and denervation control (DC). The left tibialis anterior muscle was denervated by resecting its nerve. For NMEG-NMZ, the denervated tibialis anterior was reinnervated by transferring a NMEG pedicle from the lateral gastrocnemius muscle. Three months after surgery, static toe spread analysis was performed for all rats and muscle force was measured for the rats treated with NMEG and EEA. Muscle weight, myofiber morphology, regenerated axons, and reinnervated motor endplates in the treated muscles were also quantified and compared with those in the DC group.
NMEG-NMZ technique resulted in better muscle force recovery (79% of the control) compared with EEA (51% of the control, P = .048). Toe spread analysis in NMEG-NMZ reinnervated muscles showed static sciatic index = -16.8, whereas -41.4 in EEA, P < .0001). The average weight of the NMEG-NMZ reinnervated muscles (86%) was greater than those of the EEA treated (71%) and DC (26%) muscles (all P < .0001). The mean count of the regenerated axons in the muscles with NMEG-NMZ was 76% of the control, which was larger than that in the muscles with EEA (46%), P < .0001.
NMEG-NMZ technique has unique advantages and is superior to EEA for muscle reinnervation and functional recovery.
我们开发了一种新的神经-肌肉-运动终板移植技术，称为原生运动区神经肌肉端板移植（NMEG-NMZ）。然而，目前尚不清楚 NMEG-NMZ 是否对肢体神经再支配有效。
评估 NMEG-NMZ 在外周神经肌肉再支配中的效果。
将 45 只成年大鼠分为 3 组：NMEG 组、端端吻合（EEA，技术对照组）和去神经对照组（DC）。通过切除神经来使左胫骨前肌失神经支配。对于 NMEG-NMZ，将来自外侧腓肠肌的 NMEG 蒂转移到失神经支配的胫骨前肌，以实现再神经支配。手术后 3 个月，对所有大鼠进行静态趾展分析，并对接受 NMEG 和 EEA 治疗的大鼠进行肌肉力量测量。还对处理后的肌肉中的肌肉重量、肌纤维形态、再生轴突和再支配的运动终板进行了量化，并与 DC 组进行了比较。
与 EEA（对照组的 51%，P=.048）相比，NMEG-NMZ 技术可使肌肉力量恢复更好（对照组的 79%）。NMEG-NMZ 再支配肌肉的趾展分析显示，静态坐骨神经指数为-16.8，而 EEA 为-41.4，P <.0001）。NMEG-NMZ 再支配肌肉的平均重量（86%）大于 EEA 治疗（71%）和 DC（26%）肌肉（均 P <.0001）。NMEG-NMZ 肌肉中再生轴突的平均计数为对照组的 76%，大于 EEA 肌肉（46%），P <.0001。
NMEG-NMZ 技术具有独特的优势，在肌肉再支配和功能恢复方面优于 EEA。
