Development of Targeted Muscle Reinnervation Model in Hind Limb Amputated Rats

2018 ◽  
Vol 34 (07) ◽  
pp. 509-513 ◽  
Author(s):  
Rohit Garg ◽  
Safak Uygur ◽  
Joanna Cwykiel ◽  
Maria Siemionow
Keyword(s):  
Sciatic Nerve ◽  
Hind Limb ◽  
Femoral Nerve ◽  
Biceps Femoris ◽  
Limb Amputation ◽  
Sprague Dawley ◽  
Motor Branch ◽  
Targeted Muscle Reinnervation ◽  
Hind Limbs ◽  
Muscle Reinnervation

Background Targeted muscle reinnervation (TMR) is a novel approach to postamputation neuroma pain; however, this has not been explicitly studied. The purpose of this study was to develop a TMR model in hind limb amputated rats. Methods Ten hind limbs from 5 Sprague Dawley cadaver rats were used. Sciatic nerve, main branches of the sciatic nerve (common peroneal, tibial, sural), motor branches from the sciatic nerve to the biceps femoris and cauda femoris, gluteal nerve and its motor branches to the semimembranosus, and biceps femoris and femoral nerve were dissected to look for consistent nerve anatomy that can be used for TMR in the rat hind limb amputation model. Transfemoral amputation was performed and two types of coaptations were made: common peroneal nerve to motor branch to biceps femoris and tibial nerve to motor branch to semimembranosus. Results The total surgical time for the dissection, amputation, and coaptation of nerves was ∼90 minutes. A total of 100 nerves were dissected in 10 rat hind limbs. Anatomical dissections were straightforward to perform. Anatomy of the dissected nerves was consistent. Hind limb amputations were performed without damaging the target muscles and nerves. Nerve lengths were sufficient for coaptation without any tension. Conclusions To the best of our knowledge, this is the first report on TMR model in hind limb amputated rats. This model will allow for mechanical, electromyography (EMG), and histological analysis for future assessment of neuroma prevention.

Preemptive Treatment of Phantom and Residual Limb Pain with Targeted Muscle Reinnervation at the Time of Major Limb Amputation

2019 ◽  
Vol 228 (3) ◽  
pp. 217-226 ◽  
Author(s):  
Ian L. Valerio ◽  
Gregory A. Dumanian ◽  
Sumanas W. Jordan ◽  
Lauren M. Mioton ◽  
J. Byers Bowen ◽  
...  
Keyword(s):  
Limb Amputation ◽  
Residual Limb ◽  
Limb Pain ◽  
Preemptive Treatment ◽  
Targeted Muscle Reinnervation ◽  
Muscle Reinnervation ◽  
Residual Limb Pain

Targeted Muscle Reinnervation and Osseointegration for Pain Relief and Prosthetic Arm Control in a Woman with Bilateral Proximal Upper Limb Amputation

2020 ◽  
Vol 143 ◽  
pp. 365-373
Author(s):  
Francesca Vincitorio ◽  
Guido Staffa ◽  
Oskar C. Aszmann ◽  
Maurizio Fontana ◽  
Rickard Brånemark ◽  
...  
Keyword(s):  
Pain Relief ◽  
Upper Limb ◽  
Limb Amputation ◽  
Upper Limb Amputation ◽  
Targeted Muscle Reinnervation ◽  
Muscle Reinnervation

scholarly journals Feline aortic thromboembolism: Presentation, diagnosis, and treatment outcomes of 15 cats

2020 ◽  
Vol 10 (3) ◽  
pp. 340-346
Author(s):  
Marwa H. Hassan ◽  
Ashraf M. Abu-Seida ◽  
Faisal A. T Torad ◽  
Elham A. Hassan
Keyword(s):  
Treatment Outcome ◽  
Case History ◽  
Hind Limb ◽  
Clinical Signs ◽  
Treatment Protocol ◽  
Sudden Onset ◽  
Diagnosis And Treatment ◽  
Limb Amputation ◽  
Hind Limbs ◽  
Time Of Admission

Background: Feline aortic thromboembolism (FATE) is a fatal disease where a blood clot gets lodged into the aortic trifurcation.Aim: This study describes the diagnosis and treatment outcome of FATE in 15 clinical cases.Methods: Fifteen cats with a sudden onset of hind limb paresis/paralysis, vocalization, and pain were admitted to the surgery clinic. A full case history was obtained and clinical, orthopedic, neurologic, radiographic, electrocardiographic, and echocardiographic examinations were performed for each cat. The treatment protocol included daily administration of multiple anticoagulant drugs with different mode of actions and meloxicam for 7 successive days. Prophylactic anticoagulant therapy (clopidogrel and acetylsalicylic acid) was continued for 6 months. All data were statisticallyanalyzed and the correlation between time of admission and treatment outcome was tested using Pearson’s correlation coefficient.Results: The case history and clinical, orthopedic, and neurologic examinations revealed a sudden onset of hind limbparalysis (n = 12) or paresis (n = 3) associated with vocalization and pain, absence of trauma, cold and pale paws of hind limbs (n = 13, 86.7%) or cyanosed hind paws (n = 2, 13.3%), absence of femoral pulsation, shallow and rapid open-mouth respiration (61 ± 8 breaths/minutes), hypothermia (37.9°C ± 0.6°C) and tachycardia (155 ± 12 beats/ minutes), with a muffled heart sound in four cats (26.7%). Radiography revealed no abnormalities in the hind limbs, pelvis, and spines, cardiomegaly in five cats (33.3%), mild pleural effusion and vascular pattern of the lung in six cats (40%), and Valentine’s heart shape in four cats (26.7%). Electrocardiography (ECG) revealed an R-wave< 0.9 mV, prolongation of QRS interval in five cats (33.3%), and conduction disturbance in four cats (26.7%). Echocardiography was consistent with hypertrophic cardiomyopathy (HCM) in five cats (33.3%). A statistically significant (p = 0.023) strong negative correlation (r = −0.6) was reported between time of admission and subsequent early treatment and recovery from clinical signs. The treatment was successful in nine cats (60%), while four cats (26.7) were euthanized and two cats (13.3%) were subjected to hind limb amputation, at the owners’ requests.Conclusion: Clinical signs, radiography, ECG, and echocardiography are valuable for diagnosis of FATE. The outcome of the multiple anticoagulants therapy depends mainly upon early diagnosis and treatment within the first 6 hours from the onset of clinical signs. Keywords: Anticoagulant, Aortic thromboembolism, Cardiomyopathy, Echocardiography, Paralysis.

scholarly journals Targeted muscle reinnervation for the management of pain in the setting of major limb amputation

2020 ◽  
Vol 8 ◽  
pp. 205031212095918
Author(s):  
Blair R Peters ◽  
Stephanie A Russo ◽  
Julie M West ◽  
Amy M Moore ◽  
Steven A Schulz
Keyword(s):  
Functional Limitation ◽  
The United States ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Management Options ◽  
Prosthetic Limb ◽  
Targeted Muscle Reinnervation ◽  
Muscle Reinnervation ◽  
Residual Limb Pain

The life altering nature of major limb amputations may be further complicated by neuroma formation in up to 60% of the estimated 2 million major limb amputees in the United States. This can be a source of pain and functional limitation of the residual limb. Pain associated with neuromas may limit prosthetic limb use, require reoperation, lead to opioid dependence, and dramatically reduce quality of life. A number of management options have been described including excision alone, excision with repair, excision with transposition, and targeted muscle reinnervation. Targeted muscle reinnervation has been shown to reduce phantom limb and neuroma pain for patients with upper and lower extremity amputations. It may be performed at the time of initial amputation to prevent pain development or secondarily for the treatment of established pain. Encouraging outcomes have been reported, and targeted muscle reinnervation is emerging as a leading surgical technique for pain prevention in patients undergoing major limb amputations and pain management in patients with pre-existing amputations.

scholarly journals Development of a Sheep Hind-Limb Muscle Preparation for Metabolic Studies

1986 ◽  
Vol 39 (3) ◽  
pp. 271 ◽  
Author(s):  
E Teleni ◽  
EF Annison
Keyword(s):  
Saphenous Vein ◽  
Hind Limb ◽  
Venous Blood ◽  
Muscle Metabolism ◽  
Venous Drainage ◽  
Biceps Femoris ◽  
Hind Limbs ◽  
Adductor Muscles ◽  
Hind Limb Muscle ◽  
Average Size

A sheep hind-limb preparation used for the study of muscle metabolism by arteriovenous (A V) difference procedures was validated by identifying the muscles which contribute to venous drainage at different positions along the lateral saphenous vein. Dissection of the hind limbs of six mature sheep (three wethers and three ewes) showed that venous blood from the plantar group (M. gastrocnemius, M. soleus, M. plantaris, M. flexo digitorum profundus), and from M. semitendinosus, M. biceps femoris, M. gracilis, M. pectineus and M. adductor muscles entered the lateral saphenous vein but the position of the tip of the blood sampling catheter was found to be critical. In order to sample venous blood from all of the muscles listed above, and to minimize the contribution of blood from non-muscular tissues, blood samples must be taken 25-26 cm from the junction of the cranial and caudal branches of the lateral saphenous vein (for average size sheep of body length about 108 cm and height at withers about 73 cm).

scholarly journals Targeted Muscle Reinnervation at the Time of Major Limb Amputation in Traumatic Amputees

2020 ◽  
Vol 5 (2) ◽  
pp. e0067
Author(s):  
Travis L. Frantz ◽  
Joshua S. Everhart ◽  
Julie M. West ◽  
Thuan V. Ly ◽  
Laura S. Phieffer ◽  
...  
Keyword(s):  
Limb Amputation ◽  
Targeted Muscle Reinnervation ◽  
Muscle Reinnervation

Facilitated migration of cells from a transected peripheral nerve over collagen fibers: in vivo observations

1989 ◽  
Vol 47 ◽  
pp. 888-889
Author(s):  
Arthur J. Wasserman ◽  
Azam Rizvi ◽  
George Zazanis ◽  
Frederick H. Silver
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Collagen Gel ◽  
Collagen Fibers ◽  
Control Group ◽  
Guide Tube ◽  
Sprague Dawley ◽  
Silicone Tube ◽  
Thin Sections

In cases of peripheral nerve damage the gap between proximal and distal stumps can be closed by suturing the ends together, using a nerve graft, or by nerve tubulization. Suturing allows regeneration but does not prevent formation of painful neuromas which adhere to adjacent tissues. Autografts are not reported to be as good as tubulization and require a second surgical site with additional risks and complications. Tubulization involves implanting a nerve guide tube that will provide a stable environment for axon proliferation while simultaneously preventing formation of fibrous scar tissue. Supplementing tubes with a collagen gel or collagen plus extracellular matrix factors is reported to increase axon proliferation when compared to controls. But there is no information regarding the use of collagen fibers to guide nerve cell migration through a tube. This communication reports ultrastructural observations on rat sciatic nerve regeneration through a silicone nerve stent containing crosslinked collagen fibers.Collagen fibers were prepared as described previously. The fibers were threaded through a silicone tube to form a central plug. One cm segments of sciatic nerve were excised from Sprague Dawley rats. A control group of rats received a silicone tube implant without collagen while an experimental group received the silicone tube containing a collagen fiber plug. At 4 and 6 weeks postoperatively, the implants were removed and fixed in 2.5% glutaraldehyde buffered by 0.1 M cacodylate containing 1.5 mM CaCl2 and balanced by 0.1 M sucrose. The explants were post-fixed in 1% OSO4, block stained in 1% uranyl acetate, dehydrated and embedded in Epon. Axons were counted on montages prepared at a total magnification of 1700x. Montages were viewed through a dissecting microscope. Thin sections were sampled from the proximal, middle and distal regions of regenerating sciatic plugs.

Macroanatomical Structure of the Lumbosacral Plexus and its Branches in the Indigenous Duck

2018 ◽  
Vol 52 (1-4) ◽  
pp. 1-9 ◽  
Author(s):  
MT Hussan ◽  
MS Islam ◽  
J Alam
Keyword(s):  
Hind Limb ◽  
Femoral Nerve ◽  
Morphological Structure ◽  
Spinal Nerve ◽  
The Body ◽  
Lumbar Plexus ◽  
Lumbosacral Plexus ◽  
Sacral Plexus ◽  
Spinal Nerves ◽  
Femoral Cutaneous Nerve

The present study was carried out to determine the morphological structure and the branches of the lumbosacral plexus in the indigenous duck (Anas platyrhynchos domesticus). Six mature indigenous ducks were used in this study. After administering an anesthetic to the birds, the body cavities were opened. The nerves of the lumbosacral plexus were dissected separately and photographed. The lumbosacral plexus consisted of lumbar and sacral plexus innervated to the hind limb. The lumbar plexus was formed by the union of three roots of spinal nerves that included last two and first sacral spinal nerve. Among three roots, second (middle) root was the highest in diameter and the last root was least in diameter. We noticed five branches of the lumbar plexus which included obturator, cutaneous femoral, saphenus, cranial coxal, and the femoral nerve. The six roots of spinal nerves, which contributed to form three trunks, formed the sacral plexus of duck. The three trunks united medial to the acetabular foramen and formed a compact, cylindrical bundle, the ischiatic nerve. The principal branches of the sacral plexus were the tibial and fibular nerves that together made up the ischiatic nerve. Other branches were the caudal coxal nerve, the caudal femoral cutaneous nerve and the muscular branches. This study was the first work on the lumbosacral plexus of duck and its results may serve as a basis for further investigation on this subject.

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