Koller R, Happak W, Frey M, Neumayer C, Girsch W, Liegl C, Gruber H
Abteilung für Wiederherstellende und Plastische Chirurgie, Universität Wien.
Handchir Mikrochir Plast Chir. 1997 Nov;29(6):330-4.
In order to determine the value of a reconstructive procedure in the peripheral nerve, experimental studies often evaluate the number and the diameter of myelinated nerve fibers as a parameter for the quality of regeneration. This study addresses the correlation between the number of fibers in a peripheral motor nerve after microsurgical reconstruction and the functional result, expressed as the force of the reinnervated muscle. In a total number of 24 sheep, the motor branch to the rectus femoris muscle was severed. The muscle was reinnervated either by direct neurorrhaphy or by nerve grafting, performed in three different ways (free grafting to the ipsilateral muscle, free grafting to the contralateral muscle, vascularized grafting to the ipsilateral muscle). In the final experiments, the muscle force in the reinnervated muscle was determined by supramaximal electrical stimulation. Number and diameter of myelinated nerve fibers were evaluated by computer-assisted morphometric analysis. Regression analysis of morphometric data and the muscle forces was calculated. No correlation was found between fiber numbers in the nerve graft and the maximal force. However, a positive correlation between the number of myelinated fibers in the motor branch distal to the site of coaptation and the functional result was observed in some cases. The diameter of myelinated fibers had no influence on the functional outcome.
为了确定周围神经重建手术的价值,实验研究常常将有髓神经纤维的数量和直径作为再生质量的参数来评估。本研究探讨了显微外科重建后周围运动神经纤维数量与功能结果之间的相关性,功能结果以再支配肌肉的力量来表示。在总共24只绵羊中,切断股直肌的运动分支。通过直接神经缝合或神经移植对肌肉进行再支配,神经移植以三种不同方式进行(游离移植至同侧肌肉、游离移植至对侧肌肉、带血管蒂移植至同侧肌肉)。在最终实验中,通过超强电刺激测定再支配肌肉的肌力。通过计算机辅助形态计量分析评估有髓神经纤维的数量和直径。计算形态计量数据与肌肉力量之间的回归分析。未发现神经移植中的纤维数量与最大力量之间存在相关性。然而,在某些情况下,观察到吻合部位远端运动分支中有髓纤维数量与功能结果呈正相关。有髓纤维的直径对功能结果没有影响。