scholarly journals Electrophysiologic assessment of regeneration in rat sciatic nerve repair using suture, fibrin glue or a combination of both techniques

2005 ◽  
Vol 63 (3a) ◽  
pp. 601-604 ◽  
Author(s):  
Roberto Sergio Martins ◽  
Mario Gilberto Siqueira ◽  
Ciro Ferreira da Silva ◽  
Benedito Ortiz de Godoy ◽  
José Píndaro Pereira Plese
Keyword(s):  
Sciatic Nerve ◽  
Action Potential ◽  
Fibrin Glue ◽  
Conduction Velocity ◽  
Nerve Section ◽  
Motor Action ◽  
Rat Sciatic Nerve ◽  
Nerve Action ◽  
Group A ◽  
Group B

We evaluated the repair of seccioned rat sciatic nerve by the comparison of electrophysiologic parameters. The repair was effected with suture (group A), fibrin glue (group B) or a combination of both techniques (group C). The amplitude, latency and conduction velocity of the motor and nerve action potentials were assessed before the nerve section and at reoperation after 24 weeks. There was no difference between the groups when the nerve action potential was evaluated. Rats of group B presented better results than those of group A (p<0.05) when latency and the nerve conduction velocity assessed at the reoperation, and the ratio between the conduction velocity at the reoperation and before the nerve section in the motor action potential evaluation were measured. Animals of group C presented better results than those of group A when the ratio between the conduction velocity of motor action potential at the reoperation and before the nerve division was considered (p<0.05). No difference between groups B and C was found. We conclude that repair using fibrin glue presented better results than suture following transection of sciatic nerve when the motor action potential was evaluated in the rat experimental model.

scholarly journals Nerve growth factor with fibrin glue in end-to-side nerve repair in rats

2012 ◽  
Vol 27 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Daniel Nunes e Silva ◽  
Andréia Conceição Milan Brochado Antoniolli da Silva ◽  
Ricardo Dutra Aydos ◽  
Fausto Viterbo ◽  
Elenir Rose Jardim Cury Pontes ◽  
...  
Keyword(s):  
Nerve Growth Factor ◽  
Growth Factor ◽  
Fibrin Glue ◽  
Tibial Nerve ◽  
Nerve Repair ◽  
Nerve Section ◽  
Nerve Growth ◽  
Group A ◽  
Group B ◽  
Group D

PURPOSE: To determine the effects of end-to-side nerve repair performed only with fibrin glue containing nerve growth in rats. METHODS: Seventy two Wistar rats were divided into six equal groups: group A was not submitted to nerve section; group B was submitted to nerve fibular section only. The others groups had the nerve fibular sectioned and then repaired in the lateral surface of an intact tibial nerve, with different procedures: group C: ETS with sutures; group D: ETS with sutures and NGF; group E: ETS with FG only; group F: ETS with FG containing NGF. The motor function was accompanied and the tibial muscle mass, the number and diameter of muscular fibers and regenerated axons were measured. RESULTS: All the analyzed variables did not show any differences among the four operated groups (p>0.05), which were statistically superior to group B (p<0.05), but inferior to group A (p>0.05). CONCLUSION: The end-to-side nerve repair presented the same recovery pattern, independent from the repair used, showing that the addition of nerve growth factor in fibrin glue was not enough for the results potentiating.

scholarly journals Perineural spread of pelvic malignancies to the lumbosacral plexus and beyond: clinical and imaging patterns

2015 ◽  
Vol 39 (3) ◽  
pp. E14 ◽  
Author(s):  
Stepan Capek ◽  
Benjamin M. Howe ◽  
Kimberly K. Amrami ◽  
Robert J. Spinner
Keyword(s):  
Sciatic Nerve ◽  
Lumbosacral Plexus ◽  
Perineural Spread ◽  
Tumor Spread ◽  
Spinal Nerves ◽  
Lumbosacral Plexopathy ◽  
Pelvic Cancer ◽  
Group A ◽  
Group B

OBJECT Perineural spread along pelvic autonomie nerves has emerged as a logical, anatomical explanation for selected cases of neoplastic lumbosacral plexopathy (LSP) in patients with prostate, bladder, rectal, and cervical cancer. The authors wondered whether common radiological and clinical patterns shared by various types of pelvic cancer exist. METHODS The authors retrospectively reviewed their institutional series of 17 cases concluded as perineural tumor spread. All available history, physical examination, electrodiagnostic studies, biopsy data and imaging studies, evidence of other metastatic disease, and follow-up were recorded in detail. The series was divided into 2 groups: cases with neoplastic lumbosacral plexopathy confirmed by biopsy (Group A) and cases included based on imaging characteristics despite the lack of biopsy or negative biopsy results (Group B). RESULTS Group A comprised 10 patients (mean age 69 years); 9 patients were symptomatic and 1 was asymptomatic. The L5–S1 spinal nerves and sciatic nerve were most frequently involved. Three patients had intradural extension. Seven patients were alive at last follow-up. Group B consisted of 7 patients (mean age 64 years); 4 patients were symptomatic, 2 were asymptomatic, and 1 had only imaging available. The L5–S1 spinal nerves and the sciatic nerve were most frequently involved. No patients had intradural extension. Four patients were alive at last follow-up. CONCLUSIONS The authors provide a unifying theory to explain lumbosacral plexopathy in select cases of various pelvic neoplasms. The tumor cells can use splanchnic nerves as conduits and spread from the end organ to the lumbosacral plexus. Tumor can continue to spread along osseous and muscle nerve branches, resulting in muscle and bone “metastases.” Radiological studies show a reproducible, although nonspecific pattern, and the same applies to clinical presentation.

Activity-dependent variations in conduction velocity of C fibers of rat sciatic nerve

1994 ◽  
Vol 19 (4) ◽  
pp. 427-431 ◽  
Author(s):  
Hyung-Cheul Shin ◽  
Yun-Lyul Lee ◽  
Hyeok-Yil Kwon ◽  
Hyoung Jin Park ◽  
Stephen A. Raymond
Keyword(s):  
Sciatic Nerve ◽  
Conduction Velocity ◽  
Rat Sciatic Nerve ◽  
C Fibers ◽  
Activity Dependent

scholarly journals End-to-side nerve repair using fibrin glue in rats

2010 ◽  
Vol 25 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Daniel Nunes e Silva ◽  
Julice Coelho ◽  
Fabrício de Oliveira Frazílio ◽  
Alexandre Nakao Odashiro ◽  
Paulo de Tarso Camillo de Carvalho ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Axonal Regeneration ◽  
Nerve Repair ◽  
Control Group ◽  
Morphometrical Analysis ◽  
Walking Pattern ◽  
Group A ◽  
Nerve Anastomosis ◽  
Group B ◽  
Control Group Group

PURPOSE: To evaluate axonal regeneration after end-to-side nerve repair with fibrin glue in rats. METHODS: Forty-five Wistar rats were divided into three groups: group A (n=15), were not submitted to surgery (control group); group B (n=15) were submitted to fibular transection without repair; and group C (n=15), were submitted to fibular transection with end-to-side nerve anastomosis using fibrin glue, in the lateral surface of an intact tibial nerve. The three groups were submitted to walking track (30 and 90 days) and posterior morphometrical analysis (90 days). RESULTS: The functional tests demonstrated that there was no difference in the walking track during the study in group A (p>0.05). The group B had walking pattern impairment in the two tests (p>0.05). The group C had walking pattern impairment in the first test, with important recovery in the second test (p<0.05). The morphometrical assessment revealed significantly higher number of regenerated mielinates axons in group C, compared to group B (p<0.05). CONCLUSION: The end-to-side nerve repair with fibrin glue shows axonal recovery, demonstrated through functional and morphometrical ways in rats.

scholarly journals Correlation of compound muscle action potential generated by donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury

2018 ◽  
Vol 51 (02) ◽  
pp. 137-144
Author(s):  
Mukund Ramchandra Thatte ◽  
Binita Bharat Raut ◽  
Amita Shivyogi Hiremath ◽  
Sushil Ramesh Nehete ◽  
Nayana Somala Nayak
Keyword(s):  
Action Potential ◽  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Compound Muscle Action Potential ◽  
Nerve Transfer ◽  
Elbow Flexion ◽  
Muscle Action ◽  
Muscle Action Potential ◽  
Group A ◽  
Group B

ABSTRACT Objective: To study the correlation of compound muscle action potential of donor nerves with the recovery of elbow flexion in Oberlin transfer in brachial plexus injury. Introduction: Distal nerve transfer using motor fascicle of ulnar or median nerve to restore elbow flexion is a part of reconstructive surgery after upper brachial plexus injury, first described by Oberlin et al. However, one of the most critical influences on functional outcome is number of functioning motor axons in donor fascicle which is reflected by its compound muscle action potential. We studied whether nerve transfers with donor nerves showing higher amplitudes will yield better reinnervation of muscle and therefore better function as estimated by clinical examination. Methods: We prospectively studied 30 cases of upper brachial plexus injury, of which were treated with Oberlin transfer using ulnar or median or both nerves. The prerequisites were no elbow flexion and hand and wrist flexors showing the power of more than Medical research Council MRC Grade 4. Donor nerves selected either ulnar or median having CMAP >4 mv in our electrophysiology laboratory during nerve conduction study. Patients were followed up for 1 year and assessed clinically for restoration of elbow flexion, weight tolerance. Results: A total of 30 patients of Oberlin transfer were evaluated for improvement power of biceps and elbow flexion. (MRC) grading was done at 1 year. Twenty-seven patients had a good result (MRC grade ≥3), i.e., 90% of patients. Based on the MRC grades, we categorised the patients into two groups as follows: Group A and Group B. Group A included patients with MRC Grade 4–5 and Group B included Grades 3–3.5. We tried to establish a correlation between CMAP and MRC scores by comparison of MRC grade patients for their pre CMAPs which revealed a statistically significant higher CMAPs between the groups. (Mann–Whitney U-test, P = 0.028). This indicates the association of higher pre-CMAPs with higher MRC grades. Conclusion: We conclude that higher the compound muscle action potential of donor nerves, better the recovery of elbow flexion in Oberlin transfer in brachial plexus injury.

scholarly journals Functional and electron-microscopic changes after differential traction injury in the sciatic nerve of a rat

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Soo-Hwan Byun ◽  
Kang-Min Ahn
Keyword(s):  
Sciatic Nerve ◽  
Weight Ratio ◽  
Control Group ◽  
Muscle Weight ◽  
Traction Injury ◽  
Fiber Number ◽  
Group A ◽  
Myelin Thickness ◽  
Group B ◽  
G Ratio

Abstract Background During maxillofacial trauma or oral cancer surgery, peripheral nerve might be damaged by traction injury. The purpose of this study was to evaluate functional and histomorphometric changes after traction nerve injury in the sciatic nerve of a rat model. Methods A total of 24 Sprague-Dawley rats were equally divided into three groups: unstretched (sham/control, group A), stretched with 0.7N (group B) and 1.5N (group C). Traction injury was performed for 10 min in B and C groups. Functional recovery of the sciatic nerve was evaluated by walking track analysis, toe spread test, and pinprick test 2 weeks after injury. The weight of gastrocnemius muscles of both sides was measured to evaluate weight ratio (ipsilateral/contralateral). Total number of axons, axon fiber size, myelin thickness, G-ratio, axon number/mm2, diameter of fiber, changes of longitudinal width, and formation of the edema and hematoma were evaluated by transmission electron microscopy. Results The sciatic function indexes were −11.48±4.0, −15.11±14.84, and −49.12±35.42 for groups A, B, and C, respectively. Pinprick test showed 3.0, 2.86±0.38, and 1.38±0.52 for A, B, and group C. Muscle weight ratios were 0.98±0.13 for group A, 0.70±0.10 for group B, and 0.54±0.05 for group C. There were significant differences in toe spread test, pinprick test, and muscle weight ratio between control group and experimental group (p<0.001). In the experimental group, fiber number, fiber size, G-ratio, fiber number/mm2, myelin thickness, diameter of fiber, and longitudinal width were decreased with statistical significance. Conclusion The present study demonstrated that the nerve traction injury in the rat sciatic nerve damaged the motor and sensory function and axonal integrity. The amount of functional nerve damage was proportional to the amount of traction power and dependent on the initial tensile strengths (0.7N and 1.5N).

ELECTROMYOGRAPHY, NERVE ACTION POTENTIAL, AND COMPOUND MOTOR ACTION POTENTIALS IN OBSTETRIC BRACHIAL PLEXUS LESIONS

Neurosurgery ◽  
2009 ◽  
Vol 65 (suppl_4) ◽  
pp. A153-A159 ◽  
Author(s):  
Martijn J.A. Malessy ◽  
Willem Pondaag ◽  
J. Gert van Dijk
Keyword(s):  
Action Potential ◽  
Brachial Plexus ◽  
Action Potentials ◽  
Typical Feature ◽  
Clinical Findings ◽  
Motor Action ◽  
Compound Motor Action Potential ◽  
Nerve Action ◽  
Obstetric Brachial Plexus ◽  
The Individual

Abstract OBJECTIVE Obstetric brachial plexus lesions (OBPLs) are caused by traction to the brachial plexus during labor. Typically, in these lesions, the nerves are usually not completely ruptured but form a “neuroma-in-continuity.” Even in the most severe OBPL lesions, at least some axons will pass through this neuroma-in-continuity and reach the tubes distal to the lesion site. These axons may be particularly prone to abnormal branching and misrouting, which may explain the typical feature of co-contraction. An additional factor that may reduce functional regeneration is that improper central motor programming may occur. Surgery should be restricted to severe cases in which spontaneous restoration of function will not occur, i.e., in neurotmesis or root avulsions. A major problem is how to predict whether function will be best after spontaneous nerve outgrowth or after nerve reconstructive surgery. When a decision has been made to perform an early surgical exploration, what to do with the neuroma-in-continuity can be a problem. The intraoperative appraisal is difficult and depends on experience, but even in experienced hands, misjudgment can be made. METHODS We performed an observational study to assess whether early electromyography (at the age of 1 month) is able to predict severe lesions. Additionally, the value of intraoperative nerve action potential and compound motor action potentials was investigated. RESULTS Severe cases of OBPL can be identified at 1 month of age on the basis of clinical findings and needle electromyography of the biceps. This outcome needs independent validation, which is currently in progress. Nerve action potential and compound motor action potential recordings show statistically significant differences on the group level between avulsion, neurotmesis, axonotmesis, and normal. For the individual patient, a clinically useful cutoff point could not be found. Intraoperative nerve action potential and compound motor action potential recordings do not add to the decision making during surgery. CONCLUSION The absence of a “gold standard” for the assessment of the severity of the OBPL lesion makes prognostic studies of OBPL complex. The currently available assessment strategies used to obtain the best possible solutions are discussed.

scholarly journals Comparison between Autologous Blood and Fibrin Glue for Adhering Conjunctival Autografts after Pterygium Excision- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Mona Sune ◽  
Pradeep Sune
Keyword(s):  
Clinical Trial ◽  
Fibrin Glue ◽  
Autologous Blood ◽  
Randomised Clinical Trial ◽  
Mild Degree ◽  
Group A ◽  
Pterygium Surgery ◽  
Pterygium Excision ◽  
Group B

Introduction: Fibrin glue is a biological tissue adhesive and acts on the principle of final stages of the coagulation cascade. The cost of commercially available products is very high and not affordable for the patients of low socio-economic strata. As an alternative, pterygium surgery was done using patient’s own blood to adhere the conjunctival autograft to scleral bed by the process of coagulation of fibrin from the oozing blood from the blood vessels under the flap. Aim: To compare autologous blood and fibrin glue for adhering conjunctival autografts after pterygium excision. Materials and Methods: It was a randomised clinical trial. Total 97 subjects with primary pterygium who visited the Ophthalmology Department were randomised into two groups. In group A (n=31), patients had undergone pterygium excision wherein conjunctival autograft was attached by fibrin glue. In group B (n=66) the graft was attached by autologous blood present on the scleral bed. Mean operative time for the procedures were compared. Follow- up was done for 12 months and all subjects were examined for postoperative pain, foreign body sensation, inflammation, graft stability and recurrence. Results: The mean age of patients in group A was 48.32±14.3 years (21-65 years), and in group B was 54.48±15.67 (23-74 years). Mean operating time in group A was 23.21±9.4 minutes and 13.7±4.3 minutes in group B, (p-value=0.001). Postoperative pain of mild degree was present in all the 31 (100%) subjects of group A. In group B, pain was absent in 32 (48.5%) and mild degree in 34 (51.5%) subjects. No recurrence was found in both the groups. Mean follow-up period was 11.4 months. Conclusion: This study concludes that autologous blood is a useful alternative method for graft attachment in pterygium surgery without the untoward complications related to fibrin glue.

scholarly journals A randomized controlled study of anterior lumbar plexus combined with parasacral sciatic nerve block under the guidance of ultrasound and nerve stimulator in elderly patients undergoing hip arthroplasty

2021 ◽  
Author(s):  
Wei Wu ◽  
Wen-hao Bu ◽  
Hai-bin Huang ◽  
Ying Mao ◽  
Yong-xing Tan
Keyword(s):  
Sciatic Nerve ◽  
Elderly Patients ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Skin Incision ◽  
Sciatic Nerve Block ◽  
Lumbar Plexus ◽  
Group A ◽  
Group B ◽  
First Time

Abstract Objectives: To explore the clinical application of anterior lumbar plexus combined with parasacral nerve block under the dual guidance of ultrasound and nerve stimulator in elderly hip arthroplasty.Methods: Forty elderly patients aged from 65 to 85 years old who underwent unilateral hip arthroplasty (Except for revision of hip joint) were randomly divided into two groups (n=20 in each group): ultrasound-guided anterior lumbar plexus combined with parasacral sciatic nerve block group (group A) and ultrasound-guided anterior lumbar plexus block group (group B). Both groups were assisted with sedation with different doses of dexmetopyrimidine and analgesia with different doses of sufentanil. Because the orthopaedic team of our hospital performed hip arthroplasty with mature technique and fixed operation time, the onset time of block in group An and B, heart rate and blood pressure at admission (T0), skin incision (T1), half hour after skin incision (T2) and skin suture(T3), intraoperative dosage ofdexmedetomidine and sufentanil, postoperative 1, 4, 8, 16, 24hVAS score and the first time of getting out of bed were recorded.Results: the heart rate and blood pressure at T1, T2 and T3 in group A were significantly lower than those in group B (P < 0.05). The amount of sufentanil used during operation in group), A was significantly lower than that in group B (P < 0.05). The postoperative scores of 1,4,8,16 and 24hVAS in group), A were significantly lower than those in group B (P < 0.05), and the time of getting out of bed for the first time after operation was shorter than that in group B (P < 0.05).Conclusion: compared with simple anterior lumbar plexus block, anterior lumbar plexus combined with parasacral sciatic nerve block in elderly patients with hip arthroplasty can make the intraoperative circulation more stable, the intraoperative dosage of opioids significantly reduced and the effect of early postoperative analgesia is better. it can also shorten the time for patients to get out of bed for the first time.

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