Tratnig-Frankl Philipp, Schmoll Martin, Maierhofer Udo, Klepetko Johanna, Jaklin Florian J, Jöns Lisa H, Zirak Homayon, Festin Christopher, Harnoncourt Leopold, Tereshenko Vlad, Bergmeister Konstantin D, Aszmann Oskar C
Clinical Laboratory for Bionic Extremity Reconstruction, Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Vienna, Austria.
Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.
Front Cell Dev Biol. 2025 Jun 3;13:1568935. doi: 10.3389/fcell.2025.1568935. eCollection 2025.
Brachial plexus injuries are commonly caused by stretch-traction injuries. The clinical standard is timely anatomic reconstruction with autologous nerve grafts and/or intra- or extraplexal nerve transfers. Commonly used nerve grafts are the sural nerves and/or grafts taken from the affected side. If the lower trunk has been affected, the latter nerves, however, are predegenerated. In this animal experiment we investigated, whether a degenerated nerve graft avails the same quality of regeneration as compared to a non-degenerated graft.
In this animal study, a 2 cm lesion of the right common peroneal nerve was created, and the ipsilateral sural nerve was cut or left intact to later serve as a graft. Nerve reconstruction was carried out 3 weeks later using the fresh or degenerated graft. After 6 weeks, either a retrograde labeling of the common peroneal nerve or muscle force testing was performed.
A total of 34 male SD rats, Group A ( = 13) and Group B ( = 21) were included. In Group A, the retrograde labeling of the spinal motor neurons showed an average of 66.05 (±17.03) neurons in animals with a fresh graft and 41.19 (±10.47) neurons in animals with a degenerated graft. In two animals with a fresh graft, no motor neurons could be labeled. No statistical inferiority was observed ( = 0.071). In Group B, regeneration is expressed as a recovery ratio. The fresh graft group had a mean maximum evoked contraction of 8.2 (±7.1), compared to 8.5 (±4.9) in the degenerated graft group ( = 0.462). The mean maximum twitch force was 5.2 (±3.5) and 6.4 (±4.4) respectively ( = 0.577). The mean muscle weight, comparing injured to uninjured side, was 0.32 (±0.06) in the fresh graft group and 0.32 (±0.04) in the degenerated graft group ( = 0.964).
The use of predegenerated nerve grafts for critical nerve reconstruction showed no statistical inferiority as compared to the fresh grafts in any of the evaluated outcome. Overall, these results are promising, particularly in the context of critical nerve defects involving multiple nerves, where the use of a degenerated grafts often remains the only additional source of graft material.
臂丛神经损伤通常由牵拉伤引起。临床标准是及时采用自体神经移植和/或神经丛内或神经丛外神经移位进行解剖重建。常用的神经移植物是腓肠神经和/或取自患侧的移植物。然而，如果下干受到影响，后者的神经会预先变性。在本动物实验中，我们研究了变性神经移植物与未变性移植物相比是否具有相同的再生质量。
在本动物研究中，在右侧腓总神经上制造2厘米的损伤，并切断同侧腓肠神经或使其保持完整，以便稍后用作移植物。3周后使用新鲜或变性移植物进行神经重建。6周后，对腓总神经进行逆行标记或进行肌力测试。
共纳入34只雄性SD大鼠，分为A组（n = 13）和B组（n = 21）。在A组中，脊髓运动神经元的逆行标记显示，使用新鲜移植物的动物平均有66.05（±17.03）个神经元，使用变性移植物的动物平均有41.19（±10.47）个神经元。在两只使用新鲜移植物的动物中，未标记到运动神经元。未观察到统计学上的劣势（P = 0.071）。在B组中，再生以恢复率表示。新鲜移植物组的平均最大诱发收缩为8.2（±7.1），而变性移植物组为8.5（±4.9）（P = 0.462）。平均最大抽搐力分别为5.2（±3.5）和6.4（±4.4）（P = 0.577）。比较损伤侧与未损伤侧，新鲜移植物组的平均肌肉重量为0.32（±0.06），变性移植物组为0.32（±0.04）（P = 0.964）。
在任何评估结果中，使用预先变性的神经移植物进行关键神经重建与新鲜移植物相比均未显示出统计学上的劣势。总体而言，这些结果很有前景，特别是在涉及多条神经的关键神经缺损的情况下，此时使用变性移植物往往是唯一额外的移植物材料来源。
