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KMID : 0350519950480020419
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Journal of Catholic Medical College
1995 Volume.48 No. 2 p.419 ~ p.431
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The Effect of Entubulated Nerve Conduits for Regeneration of Sciatic Nerve Gap in Rabbits
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Abstract
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Where direct approximation of the lacerated nerve with gap is not possible, the release of proximal and distal nerve ending, joint positioning, bone shortening or autogenous nerve graft would be done. But recently, a new trial to bridge the nerve
gap
with various materials as a conduit has been reported, and the entubulation concept that the potential for regeneration and functional recovery of damaged neve only exists in the presence of a suitable pathway for nerve growth is generally
accepted,
especially in nerve gap regeneration. The autogenous nerve graft is widely used to bridge the nerve gap but limited because of the sacrifying a donor nerve, and the vein interpositional graft could be done with favorable results. The similarity
between
the tubular basement membrane of skeletal muscle and the endoneurial tube also lately suggests the possiblity of autogenous degenerated muscle to aid nerve regeneration.
The experiments here assessed the chronologic influence for 9 weeks of the autogenous nerve graft, vein graft, or degenerated skeletal muscle graft entubuiated with fascia which was denatured by deep freezing with liquid N2 and thawing in
hypotonic
solution, on axonal growth for 10 mm of sciatic nerve gap in each 15 rabbits, and to survey whether degenerated muscle or vein interposition was able to serve as a nerve conduit clinically.
@ES The results obtained were as follows ;
@EN 1. Motor and sensory functions were recovered in 73.3% of the autogenous nerve graft group, in 46.7% of the degenerated muscle graft group, but in only 40.0% of the vein graft group during the experiment.
2. Nerve conduction velocity was measured to 43.37±15.76 m/sec in the mormal sciatic nerve, but it was decreased by 10.80±4.14 m/sec in the nerve graft group, 8.17±1.10 m/sec in the vein graft group, and 9.27±2.17 m/sec in the degenerated
muscle
graft group at the 9th week of experiment.
3. The number of myelinated axons of sciatic nerve in rabbit were measured by 6.600±199 mm-2. In experimental groups, total number of regenerated myelinated axons were 4.601±234 mm-2 in the nerve graft group, 2,617±362 mm-2 in the vein graft
group
and 2,121±196 mm-2 in the degenerated muscle graft group at the 6th week of experiment, but they were markdly increased by 4,714±401 mm-2, 3,408±137 mm-2 and 3,816±194-2 in each group, and it was prominent in the degenerated muscle graft
group
at
the end of experiment.
4. The number of axons are decreased in nerve graft group than normal because of nerve degeneration by blood insufficiency. No neuromas at the nerve endings were formed in the vein and degenerated muscle graft gfroups, which suggests a good
cuffing
effect with entubulation concepts in nerve gap regeneration.
Conclusively, the entubulated nerve conduits filled with ether basement membrane of degenerated skeletal muscle or autogenlous nerve would promote axonal regeneration more than the entubulated vein graft with empty in its canal, and nerve repair
using
degenrated skeletal muscle or vein graft could be employed as one of favorable nerve conduits but as a second choice after the autogenous nerve graft.
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KEYWORD
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