Sensory Reinnervation of Muscles Following Nerve Section and Suture in Cats

1985 ◽  
Vol 10 (3) ◽  
pp. 340-344
Author(s):  
R. W. BANKS ◽  
D. BARKER ◽  
H. G. BROWN

The common peroneal nerve was transected and repaired by epineurial suture in nine cats. In a further nine the nerve was transected twice and similarly repaired so as to produce a short autograft. Recovery of stretch receptors in peroneus brevis was monitored histologically and physiologically from six to fifty weeks. In recovery after single neurotomy functionally identifiable muscle-spindle and tendon-organ afferents were reduced to 25% and 45% of normal, respectively; after double neurotomy (autograft) both were reduced to about 10% of normal. Muscle spindles were reinnervated with annulospiral terminals, or wholly abnormal fine axon terminals, or both. Recovery evidently entails not only a reduction in number of stretch afferents, but also the making of some incorrect reconnections that presumably result in abnormal proprioceptive feedback and reflex action. When a graft is used the sensory impairment is compounded.

2021 ◽  
Vol 22 (3) ◽  
pp. 1401
Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana C. Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.


2005 ◽  
Vol 87-B (9) ◽  
pp. 1225-1226 ◽  
Author(s):  
N. Bottomley ◽  
A. Williams ◽  
R. Birch ◽  
A. Noorani ◽  
A. Lewis ◽  
...  

2019 ◽  
Vol 21 (1) ◽  
pp. 54-59
Author(s):  
M. G. Bashlachev ◽  
G. Yu. Evzikov ◽  
V. A. Parfenov ◽  
N. B. Vuitsyk ◽  
F. V. Grebenev

The study objective is to report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head and to discuss diagnostic methods and neurosurgical treatment. Materials and methods. We report a case of dynamic neuropathy of the common peroneal nerve at the level of the fibular head in a female patient. The patient was treated in the Neurology Clinic of I.M. Sechenov First Moscow State Medical University. We analyzed clinical manifestations and compared them with the data described in research literature. Results. Upon admission, the patient complained of pain in the anterolateral surface of the right shin and in the dorsum of the foot during walking. At rest, the patient experienced no pain. We observed no motor or sensory disorders typical of nerve root disorders at the level of L5. Lasegue’s test was negative. The patient had a positive Tinel’s sign in the area of the right fibular head. In order to clarify the diagnosis, we performed a repeated extension test in the right ankle joint and it was positive. The patient underwent surgery that included peroneal nerve decompression and neurolysis at the level of the fibular head. In the postoperative period, the patient had complete pain relief. Conclusion. Due to the difficulties in the diagnostics of dynamic neuropathy of the common peroneal nerve, this disease is often mistaken for radiculopathy at the level of L5. Thorough clinical examination, testing for Tinel’s sign in the area of the fibular head, and repeated extension test in the ankle joint ensure the correct diagnosis and reduce the frequency of ineffective surgeries on the lumbar spine. Surgical decompression of the common peroneal nerve at the level of the fibular head with obligatory opening of the entrance to the nerve canal is an effective method of treatment in such patients.


Author(s):  
Rui D. Alvites ◽  
Mariana V. Branquinho ◽  
Ana Catarina Sousa ◽  
Federica Zen ◽  
Monica Maurina ◽  
...  

Thousands of people worldwide suffer from injuries in the peripheral nerve and deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee effective outcomes, and the development of new and effective therapeutic options requires the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. In an integrative way, this article includes a detailed description of the anatomy and functionality of the peripheral nerves of sheep’s hind limb, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options. A neurological exam protocol directed to the common peroneal nerve was also established, allowing to identify the changes and deficits related with the nerve injury and to evaluate the functional progression over time. Finally, a preliminary stereological study was carried out to establish control values for the healthy peroneal common nerves of this model and to identify preliminary differences between therapeutic methods. The ultimate goal is to demonstrate that sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in human and veterinary patients.


2015 ◽  
Vol 122 (6) ◽  
pp. 1438-1443 ◽  
Author(s):  
Mika Karasawa ◽  
Kumiko Yokouchi ◽  
Akira Kakegawa ◽  
Kyutaro Kawagishi ◽  
Tetsuji Moriizumi ◽  
...  

OBJECT The purpose of this study was to determine the minimum amount of nerve fibers required to maintain normal motor function after nerve injury in rats. METHODS The authors first confirmed that a common peroneal nerve injury caused more aggravating effects on lower limb motor function than tibial nerve injury, as assessed by the static sciatic index (SSI). Thereafter, rats were subjected to varying degrees of crush injury to the common peroneal nerve. At 48 hours after the injury, motor function was assessed using the SSI and slope-walking ability (with slope angles of 30° and 45°). The tibialis anterior muscle, a main muscle innervated by the common peroneal nerve, was removed. Muscle sections were co-labeled with neuronal class III β-tubulin polyclonal antibody to identify the presence of axons and Alexa Fluor 488-conjugated α-bungarotoxin to identify the presence of motor endplates. RESULTS The evaluation of neuromuscular innervation showed a correlation between SSI scores and ratios of residual axons (rs = 0.68, p < 0.01), and there was a statistically significant difference between slope-walking ability and ratios of residual axons (p < 0.01). Moreover, the ratios of residual axons in the nerve-crushed rats with normal motor function (SSI above −20) ranged from 36.5% to 88.7%, and those ratios in the success group with slope-walking angles of 30° and 45° ranged from 14.7% to 88.7% and from 39.8% to 88.7%, respectively. CONCLUSIONS In this study of rodents, less than half of the motor axons were sufficient to maintain normal motor function of the lower limb.


2021 ◽  
Vol 14 (4) ◽  
pp. e240736
Author(s):  
Raf Mens ◽  
Albert van Houten ◽  
Roy Bernardus Gerardus Brokelman ◽  
Roy Hoogeslag

We present a case of iatrogenic injury to the common peroneal nerve (CPN) occurring due to harvesting of a hamstring graft, using a posterior mini-incision technique. A twitch of the foot was noted on retraction of the tendon stripper. After clinically diagnosing a CPN palsy proximal to the knee, the patient was referred to a neurosurgeon within 24 hours. An electromyography (EMG) was not obtained since it cannot accurately differentiate between partial and complete nerve injury in the first week after injury. Because the nerve might have been transacted by the tendon stripper, surgical exploration within 72 hours after injury was indicated. An intraneural haematoma was found and neurolysis was performed to decompress the nerve. Functioning of the anterior cruciate ligament was satisfactory during follow-up. Complete return of motor function of the CPN was observed at 1-year follow-up, with some remaining hypoaesthesia.


1948 ◽  
Vol s3-89 (6) ◽  
pp. 143-185
Author(s):  
D. BARKER

A study of the morphology and innervation of muscle-spindles from the quadriceps of the rabbit and cat has shown that: 1. The intrafusal muscle-fibres do not subdivide in their course through the spindle, as is maintained in some descriptions, but retain their individuality from pole to pole. 2. There is no constant feature which is characteristic of one pole of a spindle and not the other. A distinction can be made between the proximal and distal ends only when it is possible to orientate the spindle according to the proximal and distal ends of the muscle. The extreme ends of the spindle are attached indifferently to extrafusal endomysium, tendon, or perimysial connective tissue. 3. In the equatorial region each muscle-fibre of the spindle contains a dense aggregation of spherical central nuclei (‘nuclear bag’). On either side of this aggregation oval nuclei are disposed in the form of a chain within a central core of protoplasm (‘myotube region’). The nuclear bag is devoid of cross-striations and presumably non-contractile. The two polar portions of the muscle-fibre on either side of the bag are striated and each receives a motor innervation; hence they are presumed to function as independent contractile units. 4. The number of end-plates possessed by a spindle is approximately double its number of intrafusal muscle-fibres, with half the total number of end-plates situated at each pole. The ratio is rarely exact, since one polar half of an intrafusal fibre frequently bears two end-plates; these are innervated by nerve-fibres which retain their individuality as far as they can be traced back from the spindle. Both small nerve-fibres (3-4 µ in gold chloride preparations) and relatively large nerve-fibres (6-7 µ in gold chloride preparations) take part in the motor innervation of muscle-spindles, as was deduced on physiological grounds by Leksell (1945). 5. An analysis of the sensory innervation has confirmed many of Ruffini's (1898) observations. Primary or ‘annulo-spiral’ and secondary or ‘flowerspray’ endings occur and they are innervated by independent nerve-fibres; it is suggested that Ruffini's terms ‘primary’ and ‘secondary’ be adopted since the descriptive terms cannot always be applied. In the rabbit the secondary ending is ‘annulo-spiral’ in form and differs little from the primary ending; in the cat it is more irregular and could be termed ‘flower-spray’. The primary ending is always present and is associated with the nuclear bags of the intrafusal muscle-fibres; in some instances its ramifications are more extensive and also entwine the myotube regions. The primary ending may be the only sensory termination present, or it may be accompanied by one or by two secondary endings. These are borne by the myotube regions of the musclefibres. In the rabbit's quadriceps and interossei, spindles with one primary and one secondary ending were the most frequent in the samples taken; in the cat's quadriceps spindles with one primary and two secondary endings were the most numerous. Both the primary and secondary nerve-fibres invariably ramify so as to innervate each intrafusal fibre in the muscle-bundle. The two sensory terminations are often closely intercalated but do not overlap with one another to any great extent. As estimated from measurements made on fresh, silver, and gold chloride preparations the total diameter of the primary fibre lies between 8 and 12 µ, that of the secondary fibre between 6 and 9 µ. 6. Apart from small sympathetic fibres innervating the vascular supply of the spindle, other finer fibres may occasionally be seen ramifying within the walls of the capsule and over the polar regions. It is possible that they are somatic sensory fibres subserving the sensation of pain. 7. The nature of the reflex effects of the afferent impulses discharged by the muscle-spindle and tendon-organ is considered, and it is concluded that the balance of evidence indicates that the afferent discharge from the spindle is excitatory and that from the tendon-organ inhibitory to the motor neurones of the same muscle. However, the identification of the spindle as the receptor which excites the stretch reflex is found to rest largely upon equivocal evidence, its acceptance depending ultimately upon Matthews's finding (1933) of a considerable difference-in threshold between the spindle and tendon-organ in response to stretch. It is suggested that the large primary fibre innervating the spindle should be identified as the ‘stretch afferent’ rather than the smaller secondary fibre specified by Matthews, for the rapid con duction rate of the afferent discharge exciting the stretch reflex (Lloyd, 1943) indicates that sensory fibres of the largest diameter are employed. The functional significance of the secondary fibres is obscure and the specific reflex functions of the sensory fibres innervating both the spindle and the tendon organ clearly require further elucidation.


2016 ◽  
Vol 8 (1) ◽  
pp. 38-42
Author(s):  
Virendra Budhiraja ◽  
Rakhi Rastogi ◽  
Sanjeev K Jain ◽  
Nidhi Sharma ◽  
Rohin Garg ◽  
...  

El nervio ciático sale de la pelvis y entra en la  región glútea debajo del  músculo piriforme como un único tronco. Tiene dos componentes: el nervio peroneo común y el  nervio tibial. La relación variable del nervio ciático con el músculo piriforme y su longitud hace que el nervio sea vulnerable a las lesiones. Estudiamos la relación variable del nervio ciático en sesenta extremidades inferiores de treinta cadáveres y encontramos el nervio ciático emergiendo indiviso por debajo del músculo piriforme en el 68,33% de los casos, pero en el 31,66% el nervio ciático estaba dividido arriba en la pelvis. En el 18,33% de los casos el componente peroneo común emergió arriba y en el 13,33% de los casos emergió a través del  músculo piriforme. Pensamos que tener un conocimiento adecuado sobre la anatomía del  nervio ciático es bueno para los resultados clínicos.  Sciatic nerve leaves the pelvis and enters the gluteal region below the piriformis muscle as single trunk. It has two components common peroneal nerve and the tibial nerve. The variable relationship of sciatic nerve with the piriformis muscle and its long course makes the nerve vulnerable to injury. We studied sciatic nerve variable relation in sixty lower extremities of thirty cadavers and found the sciatic nerve emerging undivided below the piriformis muscle in 68.33% of cases but in 31.66% the sciatic nerve divided high in the pelvis. In 18.33% cases the common peroneal component emerged above and in 13.33% of cases it emerged through the piriformis muscle. We think proper knowledge of the anatomy of the sciatic nerve is good for clinical outcomes


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