| NERVE REGENERATION THROUGH A “SLIDING EPINEURIAL SHEATH TUBE” CONDUIT BY AN END-TO-SIDE COAPTATION AND ROLE OF FRESH VS. PREDEGENERATED NERVE |
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Yoon Kyu Chung |
| 이미 절단된 신경과 방금 절단된 말초 신경에서 손상 받은 신경의 원위부와 손상을 입지 않은 온전한 다른 신경의 측면을 신경외막을‘신경통로’로 이용한 단측 신경 봉합 시 신경 재생의 조직 형태학적 비교연구 |
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정 윤 규 |
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| Abstract |
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Many nerve conduits, synthetic or autogenous, have been used to bridge a nerve defect in peripheral nerve surgery experimentally or clinically. These were achieved in an end-to-end repair. Meanwhile, several reports indicated that even an end-to-side attached nerve segments were able to attract axons from the intact nerve, thereby preventing denervation atrophy of the corresponding muscles. An autogenous sliding epineurial sheath tube (SEST) constructed from the transected distal peroneal nerve was coaptated to the side of an intact tibial nerve and used as a conduit for bridging a small nerve gap in rat model. Our study was to see if a nerve can regenerate across 6-mm nerve gap from the side of an intact nerve to the cut nerve, and to compare the efficacy of fresh vs. predegenerated nerve on nerve regeneration in rats. Animals were followed at 3 weeks, 3months, 5 months, and 7 months. Evaluation included histologic examinations of the nerves, measurement of wet muscle weight of the gastrocnemius and the anterior tibial muscles, and a selective EMG. At 3 weeks, myelin-forming cells, such as Schwann cells and fibroblasts were seen in the conduit. At 7 months, numerous myelinated nerve fibers were demonstrated in the conduit. On EMG, positive compound action potential was noted both orthodromically and antidromically. The anterior tibial muscle which was initially denervated showed positive weight gain. This study showed that nerve can regenerate across 6-mm gap through a sliding epineurial sheath tube conduit even if it was attached by end-to-side fashion. |
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