Prevention of painful neuromas by oblique transection of peripheral nerves

2006 ◽  
Vol 104 (2) ◽  
pp. 285-289 ◽  
Author(s):  
Wieslaw Marcol ◽  
Katarzyna Kotulska ◽  
Magdalena Larysz-Brysz ◽  
Grazyna Bierzyñska-Macyszyn ◽  
Pawel Wlaszczuk ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Traditional Method ◽  
Healing Process ◽  
Nerve Transection ◽  
Proximal Stump ◽  
Sciatic Nerves ◽  
Neuroma Formation

Object Neuroma formation often occurs at the proximal stump of the transected nerve, complicating the healing process after gap injuries or nerve biopsies. Most such neuromas cause therapy-resistant neuropathic pain. The purpose of this study was to determine whether oblique transection of the proximal stump of the sciatic nerve can prevent neuroma formation. Methods The sciatic nerves of 10 rats were transected unilaterally at an angle of 30°, and the peripheral segments of the nerves were removed. In 10 control animals the sciatic nerves were transected at a perpendicular angle. Twenty weeks after surgery the nerves were reexposed and collected. The presence of neuromas was determined by two board-certified pathologists on the basis of histopathological evaluations. Conclusions The oblique transection of peripheral nerves, contrary to perpendicularly transected nerves, is rarely followed by classic neuroma development. Moreover, neuropathic pain is significantly reduced compared with that following the traditional method of nerve transection.

scholarly journals Tumors Provoke Inflammation and Perineural Microlesions at Adjacent Peripheral Nerves

Cells ◽  
2020 ◽  
Vol 9 (2) ◽  
pp. 320 ◽  
Author(s):  
Jennifer Cohnen ◽  
Lisa Kornstädt ◽  
Lisa Hahnefeld ◽  
Nerea Ferreiros ◽  
Sandra Pierre ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Neuronal Damage ◽  
Physical Contact ◽  
Melanoma Tumor ◽  
Inflammatory Processes ◽  
Sciatic Nerves ◽  
Tumor Types ◽  
Junction Proteins ◽  
Time Point

Cancer-induced pain occurs frequently in patients when tumors or their metastases grow in the proximity of nerves. Although this cancer-induced pain states poses an important therapeutical problem, the underlying pathomechanisms are not understood. Here, we implanted adenocarcinoma, fibrosarcoma and melanoma tumor cells in proximity of the sciatic nerve. All three tumor types caused mechanical hypersensitivity, thermal hyposensitivity and neuronal damage. Surprisingly the onset of the hypersensitivity was independent of physical contact of the nerve with the tumors and did not depend on infiltration of cancer cells in the sciatic nerve. However, macrophages and dendritic cells appeared on the outside of the sciatic nerves with the onset of the hypersensitivity. At the same time point downregulation of perineural tight junction proteins was observed, which was later followed by the appearance of microlesions. Fitting to the changes in the epi-/perineurium, a dramatic decrease of triglycerides and acylcarnitines in the sciatic nerves as well as an altered localization and appearance of epineural adipocytes was seen. In summary, the data show an inflammation at the sciatic nerves as well as an increased perineural and epineural permeability. Thus, interventions aiming to suppress inflammatory processes at the sciatic nerve or preserving peri- and epineural integrity may present new approaches for the treatment of tumor-induced pain.

Waterjet Dissection of Peripheral Nerves: An Experimental Study of the Sciatic Nerve of Rats

2010 ◽  
Vol 67 (suppl_2) ◽  
pp. ons368-ons376 ◽  
Author(s):  
Christoph A. Tschan ◽  
Doerthe Keiner ◽  
Harald D. Müller ◽  
Kerstin Schwabe ◽  
Michael R. Gaab ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Peripheral Nerves ◽  
Scar Tissue ◽  
Small Water ◽  
Peripheral Nerve Surgery ◽  
Sciatic Nerves ◽  
Nerve Surgery ◽  
Waterjet Dissection

ABSTRACT BACKGROUND: Although waterjet dissection has been well evaluated in intracranial pathologies, little is known of its qualities in peripheral nerve surgery. Theoretically, the precise dissection qualities could support the separation of nerves from adjacent tissues and improve the preservation of nerve integrity in peripheral nerve surgery. OBJECTIVE: To evaluate the potential of the new waterjet dissector in peripheral nerve surgery. METHODS: Waterjet dissection with pressures of 20 to 80 bar was applied on the sciatic nerves of 101 rats. The effect of waterjet dissection on the sciatic nerve was evaluated by clinical tests, neurophysiological examinations, and histopathological studies up to 12 weeks after surgery. RESULTS: With waterjet pressures up to 30 bar, the sciatic nerve was preserved in its integrity in all cases. Functional damaging was observed at pressures of 40 bar and higher. However, all but 1 rat in the 80 bar subgroup showed complete functional regeneration at 12 weeks after surgery. Histopathologically, small water bubbles were observed around the nerves. At 40 bar and higher, the sciatic nerves showed signs of direct nerve injury. However, all these animals showed nerve regeneration after 12 weeks, as demonstrated by histological studies. CONCLUSION: Sciatic nerves were preserved functionally and morphologically at pressures up to 30 bar. Between 40 and 80 bar, reliable functional and morphological nerve regeneration occurred. Waterjet pressures up to 30 bar might be applied safely under clinical conditions. This technique might be well suited to separate intact peripheral nerves from adjacent tumor or scar tissue. Further studies will have to show the clinical relevance of these dissection qualities.

scholarly journals Effect of Sciatic Nerve Transection on acetylcholinesterase activity in spinal cord and skeletal muscles of the bullfrog Lithobates catesbeianus

2017 ◽  
Vol 78 (2) ◽  
pp. 217-223
Author(s):  
A. Kroth ◽  
V. Mackedanz ◽  
C. Matté ◽  
A. T. S. Wyse ◽  
M. F. M. Ribeiro ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Skeletal Muscles ◽  
Ache Activity ◽  
Clinical Symptoms ◽  
Phantom Limb ◽  
Nerve Transection ◽  
Sciatic Nerve Transection ◽  
Lithobates Catesbeianus

Abstract Sciatic nerve transection (SNT), a model for studying neuropathic pain, mimics the clinical symptoms of “phantom limb”, a pain condition that arises in humans after amputation or transverse spinal lesions. In some vertebrate tissues, this condition decreases acetylcholinesterase (AChE) activity, the enzyme responsible for fast hydrolysis of released acetylcholine in cholinergic synapses. In spinal cord of frog Rana pipiens, this enzyme’s activity was not significantly changed in the first days following ventral root transection, another model for studying neuropathic pain. An answerable question is whether SNT decreases AChE activity in spinal cord of frog Lithobates catesbeianus, a species that has been used as a model for studying SNT-induced neuropathic pain. Since each animal model has been created with a specific methodology, and the findings tend to vary widely with slight changes in the method used to induce pain, our study assessed AChE activity 3 and 10 days after complete SNT in lumbosacral spinal cord of adult male bullfrog Lithobates catesbeianus. Because there are time scale differences of motor endplate maturation in rat skeletal muscles, our study also measured the AChE activity in bullfrog tibial posticus (a postural muscle) and gastrocnemius (a typical skeletal muscle that is frequently used to study the motor system) muscles. AChE activity did not show significant changes 3 and 10 days following SNT in spinal cord. Also, no significant change occurred in AChE activity in tibial posticus and gastrocnemius muscles at day 3. However, a significant decrease was found at day 10, with reductions of 18% and 20% in tibial posticus and gastrocnemius, respectively. At present we cannot explain this change in AChE activity. While temporally different, the direction of the change was similar to that described for rats. This similarity indicates that bullfrog is a valid model for investigating AChE activity following SNT.

scholarly journals Tissue Engineered Axon Tracts Serve as Living Scaffolds to Accelerate Axonal Regeneration and Functional Recovery Following Peripheral Nerve Injury in Rats

2019 ◽  
Author(s):  
Kritika S. Katiyar ◽  
Laura A. Struzyna ◽  
Joseph P. Morand ◽  
Justin C. Burrell ◽  
Basak Clements ◽  
...  
Keyword(s):  
Sciatic Nerve ◽  
Functional Recovery ◽  
Peripheral Nerves ◽  
Axonal Regeneration ◽  
Axon Regeneration ◽  
Nerve Transection ◽  
Sciatic Nerve Transection ◽  
Nerve Grafts ◽  
Axonal Regrowth ◽  
Peripheral Axon

AbstractAlthough regeneration of damaged axons in peripheral nerves has long been observed, the mechanisms facilitating this growth are not well characterized. Recently, we demonstrated that host axon regeneration could be greatly enhanced by transplanting engineered living axon tracts to guide outgrowth. Here, we used a model of rat sciatic nerve transection to explore potential mechanisms of this facilitated regeneration and its efficacy in comparison with nerve guidance tubes (NGTs) and autografts. Tissue engineered nerve grafts (TENGs) were developed via “stretch-growth” in mechanobioreactors and consisted of centimeter-scale aligned axonal tracts. Either TENGs, NGTs or autografts (reversed nerve) were then transplanted to bridge a 1 cm segmental gap in the sciatic nerve with the mechanisms of axonal regrowth assessed at 2 weeks and the extent of functional recovery assessed at 16 weeks. We observed numerous host axons growing directly along and intertwining with pre-formed axonal tracts in TENGs. This behavior appears to mimic the action of “pioneer” axons in developmental pathfinding by providing living cues for directed and accelerated outgrowth. Indeed, we found that the rates of axon regeneration were 3-4 fold faster than NGTs and equivalent to autografts. It was also observed that infiltration of host Schwann cells – traditional drivers of peripheral axon regeneration – was both accelerated and progressed directly along TENG axonal tracts. These TENG repairs resulted in levels of functional recovery equivalent to autografts, with each being several fold superior to NGT repairs. This new mechanism – which we term “axon-facilitated axon-regeneration” – may be further exploited to enhance axonal regeneration and functional recovery following neurotrauma.

Centrocentral anastomosis in the prevention and treatment of painful terminal neuroma

1985 ◽  
Vol 63 (5) ◽  
pp. 754-758 ◽  
Author(s):  
José González-Darder ◽  
José Barberá ◽  
M. José Abellán ◽  
Antonio Mora
Keyword(s):  
Sciatic Nerve ◽  
Control Parameter ◽  
Histological Study ◽  
Nerve Graft ◽  
Nerve Section ◽  
Content Type ◽  
Proximal Stump ◽  
Neuroma Formation ◽  
Fine Print ◽  
Observation Period

✓ In this experimental study, microsurgical centrocentral anastomosis was applied to an experimental model of painful terminal neuroma resulting from left sciatic nerve section in the rat. The anastomosis consisted of end-to-end suturing of the sciatic nerve fascicles to the tibial branch, with the interposition of a nerve graft taken from the same anastomosed fascicle. As a control parameter for the experiment, the autotomy which follows sciatic nerve section in the rat was evaluated. Autotomy is considered an objective indication of abnormal sensations that are provoked by the formation of a terminal neuroma. Histological study of the proximal stump of the sciatic nerve was also performed. The observation period was 10 weeks. The study demonstrates that centrocentral anastomosis reduces the size of the neuroma formation and the incidence of autotomy.

Arsenic-induced toxicity: effect on protein composition in sciatic nerve

2006 ◽  
Vol 25 (11) ◽  
pp. 667-674 ◽  
Author(s):  
A Vahidnia ◽  
F Romijn ◽  
M Tiller ◽  
G B van der Voet ◽  
F A de Wolff
Keyword(s):  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Protein Composition ◽  
Arsenic Compounds ◽  
Neurotoxic Effects ◽  
Electrophysiological Studies ◽  
Male Wistar Rats ◽  
Sciatic Nerves ◽  
L Proteins

Exposure to arsenic compounds may lead to skin and lung cancer and various disorders such as vascular disease and peripheral neuropathy in humans. Peripheral arsenic neurotoxicity has been demonstrated clinically and in electrophysiological studies. Patients intoxicated with arsenic show neurological symptoms in their feet and hands. These patients show significantly lower nerve conduction velocities (NCVs) in their peripheral nerves in comparison with controls. The mechanism of arsenic peripheral nervous system (PNS) toxicity, however, has never been described before. This is the first study to investigate the toxicity of arsenic on the PNS. Male Wistar rats were exposed to arsenite given as a single dose i.v. After sacrifice, sciatic nerves were excised and the protein composition was analysed. Protein analysis of sciatic nerves showed disappearance of neurofilament and fibroblast proteins in rats treated with arsenite doses of 15 and 20 mg/kg in comparison with the control groups. Some fibroblast protein bands had disappeared in the 20-mg/kg dose group. The analysed neurofilament-M and-L proteins decreased dose dependency over time. arsenic affects the composition of proteins in the rat sciatic nerve, especially the neurofilaments. The reduction of signals in Western blot analysis reveals changes in cytoskeletal composition, which may well lead to neurotoxic effects in vivo.

Effect of Metformin Nanoparticle-Mediated Thioredoxin Interacting Protein Expression on Oxaliplatin-Induced Peripheral Neuralgia

2020 ◽  
Vol 20 (10) ◽  
pp. 6123-6132 ◽  
Author(s):  
Yun Liu ◽  
Guangquan Zhou ◽  
Nenggui Xu
Keyword(s):  
Neuropathic Pain ◽  
Sciatic Nerve ◽  
Peripheral Nerves ◽  
Pain Perception ◽  
Thermal Sensitivity ◽  
Cancer Drug ◽  
Pain Model ◽  
Chemotherapy Drugs ◽  
Wide Range ◽  
Anti Cancer

Oxaliplatin (LOHP) is an approved anti-cancer drug that often accumulates in the peripheral nerves during the treatment of cancer. Metformin is a prescription drug with a wide range of pharmacological effects, which can augment the anti-cancer efficacy of chemotherapy drugs. Recent studies suggest that metformin is a potential drug that can relieve oxaliplatin induced neuralgia, and autophagy plays an important role in it. This study aims at exploring the effect and mechanism of action of metformin on oxaliplatin-induced peripheral neuropathic pain. To explore the underlying mechanism of metformin on peripheral nerves, neuropathic pain model was developed by intraperitoneal injection of oxaliplatin into mice. Metformin nanoparticles encapsulated by PLGA were used to intervene the pain in the model mice. RT-qPCR and immunoblotting were used to detect the effects of metformin on the expression of TXNIP and autophagy associated genes-BECN1 and LC3B in the sciatic nerves of pain model mice. Hematoxylin and eosin staining were used to detect the pathological changes in the sciatic nerve. Flow cytometry and Annexin V-FITC/PI apoptosis detection kit were used to detect the apoptosis of sciatic nerve cells. The effect of metformin on the pain perception of mice was detected by thermal and mechanical stimulation experiments. The results showed that the expression of TXNIP and autophagy related indexes-BECN1 and LC3B in sciatic nerve decreased significantly after oxaliplatin treatment. However, metformin intervention resulted in significant up-regulation of TXNIP and autophagy related indexes, and augmented the threshold of thermal sensitivity and mechanical tingling. Thus, our study has identified TXNIP as a novel target for oxaliplatin induced peripheral nerve pain. We have shown that oxaliplatin inhibits TXNIP expression, regulates autophagy, thereby affecting neuralgia. In contrast, metformin promotes the expression of TXNIP and autophagy of cells thereby inhibiting neural sensitivity and thus results in pain relief.

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