Stem cells in end-to-side neurorrhaphy. Experimental study in rats

Paiva, Geruza Rezende; Viterbo, Fausto; Deffune, Elenice; Custódio, Maria Aparecida Domingues

doi:10.1590/acb351207

Cited by 2 publications

(3 citation statements)

References 45 publications

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“…However, ETS axonal regeneration can occur even without opening an epineurial window and without sutures by simply gluing the end of the recipient nerve to the side of the donor nerve [ 40 , 41 ]. The current concept therefore is that ETS coaptation leads to collateral sprouting that occurs from the nodes of Ranvier closest to the coaptation site, along the length of the uninjured donor nerve and into the recipient nerve ( Figure 6 ) [ 40 , 41 , 42 , 43 , 44 ]. This leads us to the second question, if ETS axonal regeneration can occur without an epineurial window, is the epineurial window really necessary?…”

Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

“…Noah et al evaluated ETS coaptation in four groups: intact epineurium, epineurium window, perineurial window and partial neurectomy and noted that all groups demonstrated lateral sprouting, but the last two groups had the highest axonal count indicating that epineurium and perineurium form barriers for axonal regeneration in ETS [ 46 ]. These findings conflict with the work by Viterbo et al who used a peroneal nerve transection rat model and showed that there is no significant difference in axon counts distal to the coaptation in groups with and without perineurial windows [ 47 ].Walker et al studied the effects of perineurial window size on collateral axonal sprouting, blood-nerve barrier architecture and functional impairment of the donor nerve following small (1 mm) versus large (5 mm) perineurial windows in a rodent model of ETS between peroneal and posterior tibial nerve [ 44 ]. They found that while the larger (5 mm) perineurial window produced increased WD and worsened integrity of the blood-nerve barrier, functional recovery was not affected by the size of the perineurial window, indicating no advantage for a larger perineurial window.…”

Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

“…For instance, NT-3 and its receptor Trk C; BDNF and its receptor Trk B are upregulated at the ETS coaptation site [ 37 ]. Additionally, growth-associated protein-43 (GAP-43), a marker of growth cone formation is also upregulated [ 24 , 35 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. Finally, NGF and CNTF are upregulated and been shown to be crucial in promoting axonal regeneration following ETS [ 29 ].…”

Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

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Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Pereira

Hill

Stasyuk

et al. 2023

JCM

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Peripheral nerve injuries requiring surgical repair affect over 100,000 individuals in the US annually. Three accepted methods of peripheral repair include end-to-end, end-to-side, and side-to-side neurorrhaphy, each with its own set of indications. While it remains important to understand the specific circumstances in which each method is employed, a deeper understanding of the molecular mechanisms underlying the repair can add to the surgeon’s decision-making algorithm when considering each technique, as well as help decide nuances in technique such as the need for making epineurial versus perineurial windows, length and dept of the nerve window, and distance from target muscle. In addition, a thorough knowledge of individual factors that are active in a particular repair can help guide research into adjunct therapies. This paper serves to summarize the similarities and divergences of the three commonly used nerve repair strategies and the scope of molecular mechanisms and signal transduction pathways in nerve regeneration as well as to identify the gaps in knowledge that should be addressed if we are to improve clinical outcomes in our patients.

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Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

Section: End-to-side Nerve Coaptationmentioning

confidence: 99%

See 1 more Smart Citation

Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Pereira

Hill

Stasyuk

et al. 2023

JCM

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Nerve Injury and Peripheral Nerve Functional Loss From Injection and Suture Needles: An Experimental Study on Rats

Fernandes,

Viterbo,

Rodrigues

et al. 2023

Aesthetic Surgery Journal

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Background During invasive procedures involving needles, there is a chance of damage to peripheral nerves. Therefore, a method for experimentally simulating these situations is needed. Objectives In this study we aimed to evaluate peripheral nerve lesions caused by the entry and exit of an injection needle, nerve transfixion through a suture stitch, and the injection of saline solution and lidocaine into the nerve. Methods After obtaining approval from the Animal Ethics Committee, we randomly divided 36 Wistar rats, weighing approximately 250 g each, into 6 groups (control, sham, suture, needle, saline, and lidocaine groups), with 6 animals in each group. All procedures were performed on the left paws of the rats. After the procedure, walking track analysis was performed to assess the walking function of rats for 8 weeks. Four months after the procedures, we performed bilateral electrophysiological studies (measuring the latency and amplitude of the electrical impulse in the peroneal nerve). Subsequently, the rats were euthanized, and bilateral tissue samples were collected from the peroneal nerve and tibialis cranialis muscle for morphometric histological analysis. Results In the walking track analysis, all groups showed normalization of walking functionality after 13 days. There was little histological change between the groups, and no functional loss related to the procedures was observed. Conclusions Procedures involving the infusion of local anesthetic or saline solution, or suture needles, are safe with regard to peripheral nerve function loss. Accidents tend not to cause nerve impairment.

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Stem cells in end-to-side neurorrhaphy. Experimental study in rats

Cited by 2 publications

References 45 publications

Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Molecular Basis of Surgical Coaptation Techniques in Peripheral Nerve Injuries

Nerve Injury and Peripheral Nerve Functional Loss From Injection and Suture Needles: An Experimental Study on Rats

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