Muscle basal lamina: a new graft material for peripheral nerve repair

1986 ◽  
Vol 65 (3) ◽  
pp. 354-363 ◽  
Author(s):  
James W. Fawcett ◽  
Roger J. Keynes
Keyword(s):  
Basal Lamina ◽  
Peripheral Nerves ◽  
Nerve Repair ◽  
Graft Material ◽  
Axon Diameter ◽  
Content Type ◽  
Refractory Periods ◽  
Conduction Velocities ◽  
Sciatic Nerves ◽  
Fine Print

✓ The suitability of muscle basal lamina as a graft material for the repair of peripheral nerves was investigated. Grafts were prepared by evacuating the myoplasm from muscles excised from rats and rabbits. This produced a material consisting mainly of basal lamina and connective tissue, with the basal lamina arranged as parallel tubes. Rat- and rabbit-derived graft material in 0.5-cm lengths was sutured into rat sciatic nerves, and 4-cm lengths of rabbit-derived graft material were interposed into rabbit sciatic nerves. For controls, 0.5-cm nerve autografts were grafted into rats and 4-cm autografts into rabbits. After 2 to 3 months, the success of the grafts was assessed functionally, electrophysiologically, and anatomically. By all these criteria the basal lamina grafts were as successful as nerve autografts; essentially the same number of axons of the same size grew through both graft types, animals recovered their limb function equally well, and the nerve conduction velocities and relative refractory periods were the same in both groups of animals. In rats, following both basal lamina and nerve autografts, the number of axons distal to the grafts was approximately the same as that proximal to them, but axon diameter and speed of conduction were significantly less than normal. The authors conclude that muscle basal lamina grafts are as effective as nerve autografts for repairing severed rat or rabbit peripheral nerves, and suggest that grafts prepared in this way may prove to be useful for nerve repair in humans.

Nerve graft immunogenicity as a factor determining axonal regeneration in the rat

1990 ◽  
Vol 72 (1) ◽  
pp. 114-122 ◽  
Author(s):  
Adarsh K. Gulati ◽  
Geoffrey P. Cole
Keyword(s):  
Basal Lamina ◽  
Peripheral Nerves ◽  
Axonal Regeneration ◽  
Nerve Repair ◽  
Inbred Strains ◽  
Nerve Tissue ◽  
Freezing And Thawing ◽  
Content Type ◽  
Repeated Freezing

✓ Acellular basal lamina grafts have recently been reported to support axonal regeneration and have been used in peripheral nerve repair. The present study was designed to determine the immunogenicity of such basal lamina allografts (grafts that are genetically different) and their potential as bridging material for nerve gap repair. Inbred strains of Fischer and Buffalo rats with known histocompatibility differences were used. Acellular grafts were prepared by repeated freezing and thawing nerve tissue predegenerated in situ for 6 weeks. Non-frozen predegenerated nerves were used as cellular grafts for comparison. Fischer rats were used as hosts and received cellular or acellular grafts obtained from Fischer (isograft, genetically identical) or Buffalo (allograft) donors. The grafts were evaluated morphologically at 1,2, 4, and 12 weeks after transplantation. The cellular isografts supported axonal regeneration best. The cellular allografts were invariably rejected and were unsuccessful or only partially successful in supporting regeneration. In contrast, acellular allografts, in spite of their mild immunogenicity were successful in supporting regeneration, as were the acellular isografts. The rate of host axonal regeneration and recovery of target muscle was reduced in acellular allografts and isografts as compared to cellular isografts. It is concluded that acellular allografts are suitable for supporting axonal regeneration and may be used to bridge gaps in injured peripheral nerves.

Percussive injury to peripheral nerve in rats

1979 ◽  
Vol 51 (2) ◽  
pp. 178-187 ◽  
Author(s):  
Peter M. Richardson ◽  
Peter K. Thomas
Keyword(s):  
Peripheral Nerve ◽  
Basal Lamina ◽  
Electron Micrographs ◽  
Wallerian Degeneration ◽  
Pathological Features ◽  
Content Type ◽  
Sciatic Nerves ◽  
Fine Print

✓ Weights were dropped on rat sciatic nerves. Teased fibers and light and electron micrographs of nerves removed between 10 minutes and 2 weeks later were examined. Axonal alterations were seen 10 minutes after injury, and subsequently interruption of axonal continuity with preservation of the basal lamina was apparent. Dissolution of myelin began within 30 minutes and progressed. At 4 days, a segment of some large fibers was devoid of myelin and, by 2 weeks, remyelination had commenced. Demyelination of a significant number of fibers was always accompanied by Wallerian degeneration of other fibers of the same nerve. Percussive injury of nerves caused a mixed lesion in which the early and late pathological features were clearly distinguishable from those following crush or compression by a cuff. Any explanation of the transient interruption of function that has been described following such an injury is at present speculative.

Histological studies of experimental interfascicular graft repairs

1979 ◽  
Vol 51 (3) ◽  
pp. 333-340 ◽  
Author(s):  
Alan R. Hudson ◽  
Daniel Hunter ◽  
David G. Kline ◽  
Bert R. Bratton
Keyword(s):  
Peripheral Nerves ◽  
Nerve Repair ◽  
Light And Electron Microscopy ◽  
Distal Stump ◽  
Absorbable Suture ◽  
Myelinated Fiber ◽  
Electrical Measurements ◽  
Content Type ◽  
Fiber Size ◽  
Regenerative Activity

✓ Biopsies of sutured and grafted primate peripheral nerves were examined by light and electron microscopy after the final set of electrical measurements had been recorded. Inspection of all proximal stumps showed the expected regenerative activity which was not affected by the nature of the nerve repair. Transverse sections through the epineurial, interfascicular, and graft suture lines showed a similar pattern in all animals and at this site nerves sutured by epineurial technique could only be distinguished from those sutured by fascicular technique by loci of the non-absorbable suture. Fascicular repairs, whether done fascicle-to-fascicle or with interposition of grafts, had a more lengthy neuroma than did the epineurial repairs. Maintenance of fascicular architecture through the course of the grafts was variable. Fascicular structure was frequently absent in the central graft segments and in segments close to the second suture site. The method of repair used more proximally could not be distinguished by evaluation of distal stump segments. Measurements of myelinated fiber size made of distal stump axons revealed no statistical difference between the methods of repair.

Vertebral artery injury in C1–2 transarticular screw fixation: results of a survey of the AANS/CNS Section on Disorders of the Spine and Peripheral Nerves

1998 ◽  
Vol 88 (4) ◽  
pp. 634-640 ◽  
Author(s):  
Neill M. Wright ◽  
Carl Lauryssen
Keyword(s):  
Vertebral Artery ◽  
Neurological Deficit ◽  
Peripheral Nerves ◽  
Balloon Occlusion ◽  
Neurological Deficits ◽  
Transarticular Screw ◽  
Content Type ◽  
Iatrogenic Complications ◽  
Number Of Patients ◽  
Fine Print

Object. The 847 active members of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Section on Disorders of the Spine and Peripheral Nerves were surveyed to quantitate the risk of vertebral artery (VA) injury during C1–2 transarticular screw placement. Methods. This retrospective study elicited the number of patients treated with transarticular screws, the number of screws placed, the incidence of VA injury and subsequent neurological deficit, and the management of known or suspected VA injury. Two hundred thirteen (25.1%) of the 847 surgeons responded. One hundred one respondents (47.4%) had placed a total of 2492 C1–2 transarticular screws in 1318 patients. Thirty-one patients (2.4%) had known VA injuries and an additional 23 patients (1.7%) were suspected of having injuries. However, only two (3.7%) of the 54 patients with known or suspected VA injuries exhibited subsequent neurological deficits and only one (1.9%) died of bilateral VA injury. Other iatrogenic complications included dural tears, screw fractures, screw breakout, fusion failure, infection, and suboccipital numbness. Conclusions. Including both known and suspected cases, the risk of VA injury was 4.1% per patient or 2.2% per screw inserted. The risk of neurological deficit from VA injury was 0.2% per patient or 0.1% per screw, and the mortality rate was 0.1%. The choice of management of intraoperative VA injuries was evenly divided between placing the patient under observation and initiating immediate postoperative angiography with possible balloon occlusion.

Construction of a simple multi-lead electrode for intraoperative nerve recording

1989 ◽  
Vol 70 (6) ◽  
pp. 962-964
Author(s):  
Robert A. Ashley ◽  
Abelardo S. Wee
Keyword(s):  
Operating Room ◽  
Action Potentials ◽  
Recording Electrode ◽  
Content Type ◽  
Nerve Action ◽  
Recording Condition ◽  
Lead Electrode ◽  
Conduction Velocities ◽  
The Cost ◽  
Fine Print

✓ In the operating room, a fast and accurate means of recording nerve action potentials (NAP's) is always desirable. The multi-lead recording electrode described in this paper contains these desirable features. It can survey and obtain a number of NAP's from different nerve segments at the same time and under the same recording condition. The fixed distances between the recording leads enable quick calculation of conduction velocities of different nerve segments. Construction of the electrode is simple, and it can be designed to suit individual needs. The cost is marginal, reflecting primarily the costs of the original subdermal needle electrodes. The device is both safe and disposable.

Effects of different methods of peripheral nerve repair on the number and distribution of muscle afferent neurons in rat dorsal root ganglion

1992 ◽  
Vol 77 (3) ◽  
pp. 457-462 ◽  
Author(s):  
Lynn M. Myles ◽  
Joyce A. Gilmour ◽  
Michael A. Glasby
Keyword(s):  
Dorsal Root ◽  
Extensor Digitorum Longus ◽  
Nerve Repair ◽  
Afferent Nerve ◽  
Peripheral Nerve Repair ◽  
Content Type ◽  
Longus Muscle ◽  
Muscle Afferent ◽  
Normal Controls ◽  
Fine Print

✓ The effects of three methods of peripheral nerve repair and normal controls were compared with respect to the number and distribution of muscle afferent nerve cell bodies from the extensor digitorum longus muscle in the dorsal root ganglia of the rat. Nerves were repaired using one of three methods: 1) direct epineurial suture; 2) a three-strand cable graft; or 3) a coaxially aligned freeze-thawed autologous skeletal muscle graft. In all cases the number and distribution of muscle afferent nerve cells were estimated 300 days after nerve repair. Retrograde transport of horseradish peroxidase, injected into the extensor digitorum longus muscle, was used to identify muscle afferent nerve cell bodies in dorsal root ganglia exposed at laminectomy after fixation. It was found that all methods of nerve repair were associated with a change in both the number and distribution of labeled muscle afferent cell bodies. The number of labeled muscle afferent cells was significantly different from normal controls in all methods of repair, but was not significantly different among the three methods compared. On the other hand, cell size and cell distribution departed significantly more from normal after either of the grafting procedures than after direct repair. There was no significant difference between the two grafting techniques. These results are discussed with respect to their mechanistic and clinical interpretation.

Effects of human amniotic fluid on peripheral nerve scarring and regeneration in rats

2003 ◽  
Vol 98 (2) ◽  
pp. 371-377 ◽  
Author(s):  
Güzin Yeşim Özgenel ◽  
Gülaydan Filiz
Keyword(s):  
Peripheral Nerve ◽  
Amniotic Fluid ◽  
Nerve Regeneration ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Control Group ◽  
Human Amniotic Fluid ◽  
Content Type ◽  
Repair Site ◽  
Fine Print

Object. Peripheral nerve repair surgery is still replete with challenges. Despite technical improvements in microsurgery, classic methods of nerve repair have failed to provide satisfactory results. The purpose of this study was to investigate the effects of amniotic fluid from humans on peripheral nerve scarring and regeneration in rats. Methods. Forty adult Sprague—Dawley rats were used in this study. After the right sciatic nerve in each rat was transected and repaired using an epineural suture procedure, the nerves were divided into two groups according to the solution applied around the repair site: experimental group, 0.3 ml human amniotic fluid (HAF); and control group, 0.3 ml saline. Macroscopic and histological evaluations of peripheral nerve scarring were performed 4 weeks postsurgery. Nerves treated with HAF demonstrated a significant reduction in the amount of scar tissue surrounding the repair site (p < 0.05). No evidence of a reaction against HAF was noted. Functional nerve regeneration was measured once every 2 weeks by using a sciatic function index until 12 weeks postsurgery. Functional recovery in nerves treated with amniotic fluid occurred significantly faster than that in nerves treated with saline (p < 0.05). Peripheral nerve regeneration was evaluated histomorphologically at 12 weeks postsurgery. Nerves treated with amniotic fluid showed significant improvement with respect to the indices of fiber maturation (p < 0.05). Conclusions. Preliminary data show that HAF enhances peripheral nerve regeneration. The preventive effect of HAF on epineural scarring and the rich content of neurotrophic and neurite-promoting factors possibly contribute to this result.

Thermographic presentation of cutaneous sensory and vasomotor activity in the injured peripheral nerve

1985 ◽  
Vol 62 (5) ◽  
pp. 711-715 ◽  
Author(s):  
Kathleen L. Brelsford ◽  
Sumio Uematsu
Keyword(s):  
Elevated Temperature ◽  
Peripheral Nerve ◽  
Local Anesthesia ◽  
Peripheral Nerves ◽  
Peroneal Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Content Type ◽  
Vasomotor Activity ◽  
Fine Print

✓ Impaired function of cutaneous segments of monkey peripheral nerves experimentally blocked by lidocaine anesthesia was clearly visualized by means of elevated temperature measurements obtained on computerized color telethermography. Mean temperature elevations in the segments of anesthetized primate nerves were 2.40°C at the ulnar segment 17 minutes after nerve block, and 1.20°C at the peroneal nerve at 20 minutes. The vasomotor activity of specific nerves, recorded after local anesthesia and displayed by color telethermographic imaging, corresponded to the distribution of sensory segments identified by more cumbersome means. Telethermography is therefore shown to be a useful tool, both qualitatively and quantitatively, in mapping cutaneous distribution of peripheral nerves and for evaluation of peripheral nerve injuries.

Spatial pattern of type I collagen expression in injured peripheral nerve

1997 ◽  
Vol 86 (5) ◽  
pp. 866-870 ◽  
Author(s):  
Rahul K. Nath ◽  
Susan E. Mackinnon ◽  
John N. Jensen ◽  
William C. Parks
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Collagen Type ◽  
Collagen Type I ◽  
Type I ◽  
Collagen Production ◽  
Content Type ◽  
Spatial Expression ◽  
Sciatic Nerves ◽  
Fine Print

✓ The authors studied the spatial expression and regulation of messenger RNA for the a 1 subunit of collagen type I in crushed rat sciatic nerve to provide a basis for future therapeutic manipulation. Sciatic nerves in 20 male or female adult Lewis rats were crushed for 60 seconds; the unharmed contralateral sciatic nerves served as controls. Twenty-one days after injury the experimental animals were killed and their tissue was harvested. The spatial expression of collagen type I was determined by using in situ hybridization techniques. Quantification of fibroblast number and total signal was performed through computerized morphometry. Collagen upregulation was evident in epineurial and perineurial layers, with the epineurium displaying higher activity. The cells responsible for procollagen type I production were fibroblasts. No activity was seen in the endoneurium. Morphometric findings indicated that collagen upregulation in the epineurium and perineurium occurred at both pretranscriptional and posttranslational levels when compared to controls; a paired t-test analysis confirmed statistical significance for all comparisons between injured and control tissues. Epineurial fibroblasts are responsible for the collagen production associated with crushed peripheral nerve injury in the rat. Regulation occurs pretranscriptionally as well as posttranslationally. It is interesting to speculate that the delivery of agents directed against collagen production (such as neutralizing antibodies to growth factors) into epineurial tissues proximate to the time and location of clinical nerve injury might mitigate later deleterious effects of excess collagen production in axonal regeneration.

Recovery of cutaneous pain sensitivity after end-to-side nerve repair in the rat

1999 ◽  
Vol 91 (5) ◽  
pp. 857-862 ◽  
Author(s):  
Uroš Kovačič ◽  
Fajko Bajrović ◽  
Janez Sketelj
Keyword(s):  
Sural Nerve ◽  
Peroneal Nerve ◽  
Pain Sensitivity ◽  
Nerve Repair ◽  
Sensory Function ◽  
Morphological Evidence ◽  
Content Type ◽  
Collateral Sprouting ◽  
Sensory Axons ◽  
Fine Print

Object. The hypothesis that collaterally sprouting axons from an uninjured donor nerve may provide recovery of pain sensitivity in the skin after end-to-side nerve repair was investigated in rats. In addition, the effect of this technique on the donor nerve was examined.Methods. The distal stump of the transected peroneal nerve was sutured end to side to the intact sural nerve. No epineurial window or perineurial slit was made in the sural nerve at the site of coaptation. Other nerves in the leg were transected and ligated. Eighteen weeks later, the sural nerve was transected at a site distal from the coaptation site. The residual pain sensitivity in the peroneal innervation field in the instep was documented using the skin pinch test in three of 11 animals. The area of sensitivity encompassed 19 to 40% of the maximum nociceptive innervation area of the normal peroneal nerve. The nerve pinch test revealed functional sensory axons in all communicating peroneal nerves, in which 277 ± 119 myelinated axons (mean ± standard deviation) were found by histological investigation.Conclusions. The authors conclude that at least partial recovery of sensory function due to collateral sprouting of axons after end-to-side nerve repair is possible in principle. However, the presence of functional sensory axons in the peroneal nerve stumps did not guarantee the recovery of skin sensitivity to pain in all animals. No functional or morphological evidence of an untoward effect of collateral sprouting into the end-to-side communicating nerve was detected in the axons of the donor nerve itself.

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