scholarly journals Comparison of nerve graft integration after segmentar resection versus epineural burying in crushed rat sciatic nerves

1997 ◽  
Vol 12 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Marco Túlio Rodrigues da Cunha ◽  
Alcino Lázaro da Silva ◽  
Sheila Bernardino Fenelon
Keyword(s):  
Sciatic Nerve ◽  
Sural Nerve ◽  
Wallerian Degeneration ◽  
Nerve Graft ◽  
Nerve Grafts ◽  
Nerve Segment ◽  
Sciatic Nerves ◽  
Group 2 ◽  
Crushed Nerve ◽  
Group 1

The aim of the present paper is to compare and correlate the take of nerve segments in a severely crushed nerve. Forty adult Wistar rats had their right sciatic nerve by a "Péan-Murphy" forceps for 40 minutes. In Group 1 (n=20), a segmentar serection in the crushed sciatic nerve was made. A sural nerve segment from the opposite hindpaw was placed in the gap. In Group 2 (n=20), a lontudinal insision in the epineurium of the lesioned sciatic nerve was made. A sural nerve segment was buried underneath the epineurium. The crushed sciatic nerves undergone Wallerian degeneration and endoneurial fibrosis. Sciatic nerves from Group 2 had significant better histological aspects than those from Group 1. Sural nerve grafts presented better degrees of regeneration than crushed sciatic nerves. Sural nerve grafts from Group 2 (burying method) integrated as well as those from Group 1 (segmentar resection).

scholarly journals Partial epineural burying of nerve grafts with different sizes next to or distant from neurorrhaphy’s site: histological and electrophysiological studies in rat sciatic nerves

2001 ◽  
Vol 16 (4) ◽  
pp. 187-194
Author(s):  
Marco Túlio Rodrigues da Cunha ◽  
Alcino Lázaro da Silva ◽  
Maria das Graças Reis ◽  
Valdo José Dias da Silva
Keyword(s):  
Nerve Fiber ◽  
Sural Nerve ◽  
Electrophysiological Study ◽  
Nerve Fibers ◽  
Nerve Graft ◽  
Nerve Grafts ◽  
Group 3 ◽  
Sciatic Nerves ◽  
Sural Nerve Graft ◽  
Group 1

The aim of the present study was to compare and correlate histologically and electromyographically the effects of partial epineural burying of sural nerve segments in sectioned and sutured rat sciatic nerves. Sixty adult male Wistar rats were operated on 3 groups: Group 1, sural nerve graft, 9mm long, placed next to neurorrhaphy; Group 2, sural nerve graft, 9mm long, buryied 10mm distant from neurorrhaphy; Group 3, sural nerve graft, 18mm long, set next to neurorrhaphy. The morphological features were examined at light microscope after 3 months in 45 rats. The elements observed were: vascularization, vacuoles in nerve fibers, mastocytes and inflammatory infiltrate. The morphometry was made after 6 months in 15 rats from Group 1, 2 and 3, measuring external nerve fiber diameters and counting myelinated nerve fibers/mm². The electrophysiological study was perfomed after 6 months, registering maximum amplitude and frequency of EMG pontentials, at rest, in extensor digitorum longus muscle. Group 3 rats presented sciatic nerves better conserved morphologically and mean external nerve fiber diameters greater than those from Groups 1 and 2. There were no significant differences in density of nerve fibers/mm², and in the electrophysiological study in rats from Group 1, 2 and 3. The epineural burying of sural nerve grafts with greater length and placed next to the neurorrhaphy’s site had a significantly better regeneration of the histological features than the smaller ones distant from neurorrhaphy.

scholarly journals Reconstruction of Sciatic Nerve Using Bilateral Vascularized Sural Nerve Grafts: A Case Report

2021 ◽  
Author(s):  
Si-Gyun Roh ◽  
Jae Young Chun ◽  
Nae-Ho Lee ◽  
Jin Yong Shin ◽  
Jong-Lim Kim
Keyword(s):  
Case Report ◽  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Tumor Resection ◽  
Nerve Graft ◽  
Sensory Function ◽  
Nerve Grafts ◽  
Function Recovery ◽  
Sural Nerve Graft

Injury of peripheral nerve may require reconstruction for motor and sensory function recovery. However, when the nerve defect is long, especially in the lower extremities, reconstruction with successful function recovery proved to be difficult. We documented a case of bilateral vascularized sural nerve graft repair of a large and long sciatic nerve defect following malignant tumor resection on posterior thigh. Although we were unable to achieve satisfactory outcomes in motor function recovery, we did accomplish some sensory function recovery.

Histological assessment of nerve lesions caused by epineurial electrode application in rat sciatic nerve

1991 ◽  
Vol 74 (4) ◽  
pp. 636-642 ◽  
Author(s):  
Werner Girsch ◽  
Rupert Koller ◽  
Helmut Gruber ◽  
Jürgen Holle ◽  
Christian Liegl ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Steel Wire ◽  
Neural Tissue ◽  
Content Type ◽  
Group 3 ◽  
Sciatic Nerves ◽  
Group 2 ◽  
The Right ◽  
Group 1

✓ The left sciatic nerve of 36 rats was exposed and four ring-shaped stainless steel wire electrodes were sutured to the epineurium of each nerve in the same manner as performed clinically for “carousel stimulation” in man. The rats were sacrificed 10 days (Group 1), 3 weeks (Group 2), or 3 months (Group 3) after implantation. The electrodes were excised, the nerves were embedded in Epon, and semithin sections were obtained for histological and planimetric assessment of lesions caused by the epineurially sutured electrodes. The right sciatic nerves served as controls. The total area of neural tissue within the perineurium was determined at three levels: at the site of the electrodes, 8 mm proximal, and 8 mm distal. The area of neural tissue damaged by the surgical procedure was expressed as a percentage of the total area. In Group 1, nine of 12 nerves showed lesions ranging from 0.39% to 25.39% of the total area of neural tissue, in Group 2 eight of 11 sciatic nerves showed lesions ranging from 0.24% to 13.03% of the total area, and in Group 3 five of 12 nerves showed lesions ranging from 0.21% to 4.96% of the total area. The pathologically altered areas in Groups 2 and 3 exhibited distinct signs of nerve fiber regeneration. The reasons for the decrease in damage from Group 1 to Group 3 and the clinical implications of the results for long-term electrical stimulation are discussed.

Recurrent Laryngeal Nerve Regeneration by Tissue Engineering

2003 ◽  
Vol 112 (6) ◽  
pp. 492-498 ◽  
Author(s):  
Shin-Ichi Kanemaru ◽  
Koichi Omori ◽  
Yasuyuki Hiratsuka ◽  
Hisayoshi Kojima ◽  
Juichi Ito ◽  
...  
Keyword(s):  
Recurrent Laryngeal Nerve ◽  
Compound Muscle Action Potential ◽  
Polyglycolic Acid ◽  
Nerve Graft ◽  
Laryngeal Nerve ◽  
Nerve Conduit ◽  
Surgical Methods ◽  
Functional Regeneration ◽  
Group 2 ◽  
Group 1

The recurrent laryngeal nerve (RLN) does not regenerate well after it has been cut, and no current surgical methods achieve functional regeneration. Here, we evaluate the functional regeneration of the RLN after reconstruction using a biodegradable nerve conduit or an autologous nerve graft. The nerve conduit was made of a polyglycolic acid (PGA) tube coated with collagen. A 10-mm gap in the resected nerve was bridged by a PGA tube in 6 adult beagle dogs (group 1) and by an autologous nerve graft in 3 dogs (group 2). Fiberscopic observation revealed functional regeneration of the RLN in 4 of the 6 dogs in group 1. No regeneration of the RLN was observed in any dog in group 2. We also tested for axonal transport, and measured the compound muscle action potential. The RLN can be functionally regenerated with a PGA tube, which may act as a scaffold for the growth of regenerating axons.

scholarly journals First human experience with autologous Schwann cells to supplement sciatic nerve repair: report of 2 cases with long-term follow-up

2017 ◽  
Vol 42 (3) ◽  
pp. E2 ◽  
Author(s):  
Zachary C. Gersey ◽  
S. Shelby Burks ◽  
Kim D. Anderson ◽  
Marine Dididze ◽  
Aisha Khan ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Sural Nerve ◽  
Gunshot Wound ◽  
Nerve Repair ◽  
Nerve Graft ◽  
Sensory Function ◽  
Long Term Follow Up

OBJECTIVE Long-segment injuries to large peripheral nerves present a challenge to surgeons because insufficient donor tissue limits repair. Multiple supplemental approaches have been investigated, including the use of Schwann cells (SCs). The authors present the first 2 cases using autologous SCs to supplement a peripheral nerve graft repair in humans with long-term follow-up data. METHODS Two patients were enrolled in an FDA-approved trial to assess the safety of using expanded populations of autologous SCs to supplement the repair of long-segment injuries to the sciatic nerve. The mechanism of injury included a boat propeller and a gunshot wound. The SCs were obtained from both the sural nerve and damaged sciatic nerve stump. The SCs were expanded and purified in culture by using heregulin β1 and forskolin. Repair was performed with sural nerve grafts, SCs in suspension, and a Duragen graft to house the construct. Follow-up was 36 and 12 months for the patients in Cases 1 and 2, respectively. RESULTS The patient in Case 1 had a boat propeller injury with complete transection of both sciatic divisions at midthigh. The graft length was approximately 7.5 cm. In the postoperative period the patient regained motor function (Medical Research Council [MRC] Grade 5/5) in the tibial distribution, with partial function in peroneal distribution (MRC Grade 2/5 on dorsiflexion). Partial return of sensory function was also achieved, and neuropathic pain was completely resolved. The patient in Case 2 sustained a gunshot wound to the leg, with partial disruption of the tibial division of the sciatic nerve at the midthigh. The graft length was 5 cm. Postoperatively the patient regained complete motor function of the tibial nerve, with partial return of sensation. Long-term follow-up with both MRI and ultrasound demonstrated nerve graft continuity and the absence of tumor formation at the repair site. CONCLUSIONS Presented here are the first 2 cases in which autologous SCs were used to supplement human peripheral nerve repair in long-segment injury. Both patients had significant improvement in both motor and sensory function with correlative imaging. This study demonstrates preliminary safety and efficacy of SC transplantation for peripheral nerve repair.

scholarly journals Donor nerve graft assessment for covering thumb nerve defects: a cadaveric study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hamid Namazi ◽  
Ahmad Sobhani ◽  
Saeed Gholamzadeh ◽  
Amirreza Dehghanian ◽  
Fatemeh Dehghani Nazhvani
Keyword(s):  
Surface Area ◽  
Sural Nerve ◽  
Nerve Graft ◽  
Cutaneous Nerve ◽  
Digital Nerve ◽  
Cross Sectional ◽  
Nerve Grafts ◽  
Anterior Interosseous Nerve ◽  
The Mean ◽  
Graft Selection

Abstract Background Even though several studies reported donor autologous nerve grafts for digital nerve defects, there is no report in the literature regarding acceptable graft for thumb nerves. The purpose of this study is to provide guidelines for autologous nerve graft selection by detecting similarities between thumb nerve zones and donor nerve with regard to the number of fascicles and cross-sectional area. Materials and methods Five cadavers were used in this study. An anatomical zoning system was defined for thumb nerves (zones 1, 2, 3). Sural nerve (SN), medial antebrachial cutaneous nerve (MABCN), lateral antebrachial cutaneous nerve (LABCN), posterior interosseous nerve (PIN), and anterior interosseous nerve (AIN) were selected as donor nerve grafts. The number of fascicles and surface area (mm2) was defined. Results The mean of the fascicle number in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 3.8, 4.7, 6.1, 2.2, 1.8, 4.5, 3.1, and 6.4, respectively. The mean of the surface area in zone 1, zone 2, zone 3, AIN, PIN, LABCN, MABCN, and SN were 2.19, 6.26, 4.04, 1.58, 0.71, 5.00, 3.01, and 8.06, respectively. Conclusions LABCN is the best choice for all zones that has fascicular matching with all three zones of thumb nerves and caliber matching with zones 2 and 3. In zone 1, the best nerve graft is MABCN which has both suitable caliber and fascicle count.

Neural regeneration along longitudinal polyglactin sutures across short and extended defects in the rat sciatic nerve

2001 ◽  
Vol 95 (2) ◽  
pp. 316-323 ◽  
Author(s):  
Peter Scherman ◽  
Göran Lundborg ◽  
Martin Kanje ◽  
Lars B. Dahlin
Keyword(s):  
Sciatic Nerve ◽  
Neural Regeneration ◽  
Extended Defects ◽  
Force Measurements ◽  
Neurofilament Protein ◽  
Content Type ◽  
Nerve Grafts ◽  
Rat Sciatic Nerve ◽  
Nerve Segment ◽  
Fine Print

Object. The authors have previously shown that longitudinal sutures without artificial tube support regeneration across a 7-mm gap in the rat sciatic nerve. In the present study, the authors compared this new approach with the use of autologous nerve grafts across short defects and examined whether the approach could be used to support regeneration across extended gaps and whether the interposition of a short nerve segment (the stepping-stone procedure) was applicable in this model. Methods. Longitudinal sutures were used to bridge 7- and 15-mm gaps in the rat sciatic nerve. Contralateral comparisons were made to nerve autografts in the 7-mm group and to sutures plus a short interposed nerve segment in the 15-mm group. Regeneration was evaluated at 2, 4, and 12 weeks by using immunocytochemical analysis for Schwann cells, neurofilament protein, and macrophages and at 12 weeks also by using histological examination, including morphometry in the distal tibial trunk and tetanic force measurements in the gastrocnemius muscle. Conclusions. The authors found that the results of regeneration after repair with longitudinal polyglactin sutures across short defects were not significantly different from those produced by the use of autologous nerve grafts. Regeneration, although poor, occurred along sutures across extended gaps and was significantly enhanced by an interposed nerve segment acting as a Schwann cell resource in this model.

scholarly journals The effect of gluteus maximus tenotomy in primary total hip arthroplasty with posterior approach: Kinematic analysis of hip extensor strength

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902110033
Author(s):  
Yunus Imren ◽  
Bulent Karslioglu ◽  
Suleyman Semih Dedeoglu ◽  
Haluk Cabuk ◽  
Sevgi Atar ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Sciatic Nerve ◽  
Total Hip Arthroplasty ◽  
Body Mass ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Gluteus Maximus ◽  
Harris Hip Score ◽  
Group 2 ◽  
Group 1

Background: The posterior approach (PA) is the most commonly used surgical approach for total hip arthroplasty (THA), but the proximity of the sciatic nerve may increase the likelihood of sciatic nerve injury (SNI). Gluteus maximus tenotomy can be performed to prevent SNI because tenotomy increases the distance between the femoral neck and sciatic nerve and prevents compression of the sciatic nerve by the gluteus maximus tendon (GMT) during hip movements. We aimed to kinematically compare the postoperative hip extensor forces of patients who have and have not undergone gluteus maximus tenotomy to determine whether there is a difference in hip extensor strength. Methods: Seventy-two patients who underwent gluteus maximus tenotomy during THA were included in the group 1, and 86 patients who did not undergo tenotomy were included in group 2. The Harris hip score, body mass index and hip extensor forces were measured both preoperatively, and 6 months after surgery with an isokinetic dynamometer and compared. Results: The mean age was 64.6 ± 2.3 years in group 1 and 63.8 ± 2.1 in group 2. Mean body mass index was 25.7 ± 1.1 in group 1, and 25.5 ± 1.3 in group 2. Baseline Harris hip score (HHS) was 42.36 ± 12 in group 1 and 44.07 ± 9.4 in group 2 (p = 0.31), whereas it was 89.1 ± 7.8 and 88.4 ± 8.1 at 6 months after surgery, respectively. Baseline hip extensor force (HEF) was 2 ± 0.4 Nm/kg in group 1, and 2.1 ± 0.7 Nm/kg in group 2 (p = 0.28), while it was 2.4 ± 0.6 Nm/kg, and 2.5 ± 0.5 Nm/kg, respectively at 6 month follow-up (p = 0.87). Both groups had significantly improved HHS and HEF when comparing baseline and postoperative measurements (p < 0.0001). No cases of sciatic nerve palsy were noted in group 1, whereas there were two (2.32%) cases in group 2, postoperatively. Conclusion: The release of the GMT during primary hip arthroplasty performed with the PA did not lead to significant decrease in hip extension forces. Hip extensor strength improves after THA regardless of tenotomy. Gluteus maximus tenotomy with repair does not reduce muscle strength and may offer better visualization.

scholarly journals Laparoscopic morphological aspects and tentative explanation of the aetiopathogenesis of isolated endometriosis of the sciatic nerve: a review based on 267 patients

2021 ◽  
Vol 13 (4) ◽  
pp. 369-375
Author(s):  
M Possover
Keyword(s):  
Sciatic Nerve ◽  
Lower Limb ◽  
Neurological Disorders ◽  
Retroperitoneal Fibrosis ◽  
Lower Limbs ◽  
Foot Drop ◽  
Time Interval ◽  
Morphological Aspects ◽  
Group 2 ◽  
Group 1

Background: Endometriosis of the sciatic nerve (ESN) is considered a rare disease. How can endometriosis develop within the sciatic nerve; a structure which has nothing in common with the uterus either anatomically or functionally, and why it occurs in the absence of any retroperitoneal/parametric endometriosis, is unknown. A better understanding of the pathophysiology of this enigmatic disease may improve its diagnosis and therapy. Materials and Methods: From a pool of 452 patients operated for ESN, only patients with “isolated” endometriosis of the sciatic nerve” confirmed at laparoscopy were included in this study. Patients with suspicion of ESN by extension from a parametric, ovarian or other intraperitoneal deeply infiltrating endometriosis were excluded from this study. Main outcome measure: All information acquired during the preoperative patient’s medical history and clinical examination were collected and compared with the morphological aspects of the disease observed by the laparoscopic treatment. Patients were classified into three groups according to the time interval between the onset of sciatic pain and the time of surgery: less than 1 year (Group 1), between 1 and 3 years (Group 2), and more than 3 years (Group 3). Results: Two hundred sixty-seven consecutive patients were included in this study. In Group 1 (n=67), 76% of the patients presented with cyclical sciatica, without sensory or motor disorders of the lower limbs. Laparoscopic exploration found in the great majority of these patients only the presence of an isolated endometrioma in the nerve itself, the size of which was proportional to the time elapsed since the onset of pain. In Group 2 (n=83), pain had become constant in 91% of the patients with neurological disorders of the lower limb (foot drop, Trendelenburg gait, atrophied muscles) in about 30% of patients. Laparoscopic examination revealed, in addition to intraneural cystic lesions, a retroperitoneal fibrosis in more than 80% of the patients. In the third group (N=117), more than 80% of the patients presented with neurological disorders of the lower limb, with, on laparoscopic examination, massive retroperitoneal fibrosis with endometriomas in the nerve and adjacent pelvic wall muscles in all patients and an infiltration of the obturator nerve in 41% of patients. Conclusions: The different morphologic aspects of ESN do not correspond to different forms of the disease, but obviously to one single disease at different stages of its evolution. ENS starts first with the development of an endometrioma within the sciatic nerve, then develops in a second step a perineural fibrosis that expands into the whole retroperitoneal space and finally involves surrounding anatomical structures. The ESN is a very particular pathology because it induces a completely new aspect on the pathogenesis of endometriosis: all hypothesis of implanted endometrial cells following retrograde menstruation, angiogenic spread, lymphogenic spread or the metaplasia theory cannot explain the pathogenesis of this disease. ESN obviously does not develop from “genital metastatic cells”. A possible hypothesis for explanation the pathogenesis of ESN, could consist in the development of endometriosis of the nerve from progenitor stem cells present within the nerve, pluripotent cells which, for an as yet unknown reason (possibly in connection with iterative inflammations and micro-damages of the nerve itself), mutate and proliferate to form endometriosis.

scholarly journals Effect of auto-transplantation of bone marrow on the nerve autography in the dogs

2011 ◽  
Vol 11 (2) ◽  
pp. 128
Author(s):  
O.H. Al-Hyani
Keyword(s):  
Bone Marrow ◽  
Sciatic Nerve ◽  
Median Nerve ◽  
Clinical Observation ◽  
Nerve Repair ◽  
Nerve Graft ◽  
Absorbable Suture ◽  
Histological Changes ◽  
Nerve Segment ◽  
Normal Physiological Function

The research was conducted to study the repair of transected sciatic nerve through by grafting sciatic nerve with nerve segment and addition of bone marrow in dogs. Twelve adult dogs from both sexes was used. They was divided into two groups, six animals in each group. The left sciatic nerve was used as a model in this research for monitoring the process of nerve repair. In group one, the sciatic nerve was transected and a piece of nerve about 1cm in length was removed, and the resultant gap was repaired by autotransplantation with a segment of nerve harvested from the median nerve of the forelimb with the consideration that the harvested median nerve segment was slightly longer than the resected sciatic nerve segment. The implanted nerve segment was sutured with sciatic nerve using non absorbable suture (nylon 5\0). In group two, the same surgical procedure was performed as in group one, but a bone marrow that aspirated from the same animal was applied on the nerve transplantation. The assessment of sciatic nerve repair was accomplished by studying the clinical observation of normal physiological function of the operated limb, additionally studying the histological changes on the nerve graft transplantation at 30 and 45 postoperative days. The study was revealed, the application of bone marrow on the nerve graft segment was enhanced the degree of healing of transected sciatic nerve that indicated by improvement the functional use of affect hind limb clinically, with improvement the vasculrization of nerve graft segment and increase proliferation of nerve cells (Schwann and microglial cells) with extension of collagen fibers that aid to bridge the sciatic nerve with grafted nerve segment histologicaly rather than in group one.In conclusion the addition of bone marrow on the nerve graft segment accelerate the degree of healing of transected sciatic nerve with improve the functional use of operated limb.

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