Comparison of repair of peripheral nerve transection in predegenerated muscle with and without a vein graft

Abstract

BackgroundDespite substantial research into the topic and valiant surgical efforts, reconstruction of peripheral nerve injury remains a challenging surgery. This study was conducted to evaluate the effectiveness of axonal regeneration of a transected sciatic nerve through a vein conduit containing degenerated skeletal muscle compared with axonal regeneration in a transected sciatic nerve through degenerated skeletal muscle alone.MethodsIn two of the three experimental rat groups, 10 mm of the left sciatic nerve was transected and removed. The proximal and distal ends of the transected sciatic nerve were then approximated and surrounded with either (a) a degenerated skeletal muscle graft; or (b) a graft containing both degenerated skeletal muscle and vein. In the group receiving the combined vein and skeletal muscle graft, the vein walls were subsequently sutured to the proximal and distal nerve stump epineurium. Sciatic functional index (SFI) was used for assessment of functional recovery. Tracing study and histological procedures were used to assess axonal regeneration.ResultsAt 60 days, the gait functional recovery as well as the mean number of myelinated axons in the middle and distal parts of the sciatic nerve significantly increased in the group with the vein graft compared to rats with only the muscular graft (P < 0.05). Mean diameter of myelinated nerve fiber of the distal sciatic nerve was also improved with the vein graft compared to the muscle graft alone (P < 0.05). The mean number of DiI-labeled motor neurons in the L4-L5 spinal segment increased in the vein with muscle group but was not significantly different between the two groups.ConclusionsThese findings demonstrated that a graft consisting of not only predegenerated muscle, but also predegenerated muscle with vein more effectively supported nerve regeneration, thus promoting functional recovery after sciatic nerve injury in rats.

Partially oxidized polyvinyl alcohol conduitfor peripheral nerve regeneration

“…scarring and neuroma formation, permanent loss of function), size mismatch between the donor nerve and the injured one, poor functional recovery rates and increase in surgery and anesthesia time, have prompted the interest towards the identification of surgical alternatives to this technique 5 – 7 . Currently, the primary option is the use of hollow nerve guide conduits that will create an adequate microenvironment for nutritional support, axon regeneration and acting as a barrier against the surrounding tissue infiltration 8 , 9 . Autologous non-nerve tissues (i.e.…”

The Effect of Muscle Graft with Nerve Growth Factor and Laminin on Sciatic Nerve Repair in Rats

“…Peripheral nerve injury is a major problem that annually affects millions of people in the world, and most cases require surgical nerve repair (Perretta & Green, 2017). A grafting procedure is necessary to improve the functional recovery when a long segment of the nerve is lost (Mohammadi, Delaviz, Mohammadi, Delaviz, & Rad, 2016). When there is a large gap between the nerve endings, a suitable anatomical conduit is necessary so that the axons in the proximal segment can be guided into the endoneurial tubes of the distal segment and restore the function of the target organ (Iijima, Ajiki, Murayama, & Takeshita, 2016).…”

Restoration of Neurological Function Following Peripheral Nerve Trauma

“…A meta-analysis of published papers determined that for nerve gaps up to 4 cm in length, vein conduits did not induce any significant improvement in sensory recovery outcome compared to conduits of other materials [170]. However, the axon regeneration-promoting efficacy of vein conduits is enhanced when they are filled with PRP [171][172][173], muscle [174], pre-degenerated muscle [175,176], muscle seeded with neural-transdifferentiated human mesenchymal stem cells [177], and minced peripheral nerves [178]. One study in sheep showed that using the median epineural sheath as a conduit can restore median nerve function across 6-cm-long nerve gaps [179].…”