End-to-side anastomosis of peripheral nerve in experimental and clinical model
| Authors | |
|---|---|
| Year of publication | 2004 |
| Type | Article in Proceedings |
| Conference | DEVELOPMENTS IN NEUROSCIENCES |
| MU Faculty or unit | |
| Citation | |
| Field | Neurology, neurosurgery, neurosciences |
| Keywords | brachial plexus; reconstruction; end-to-side anastomosis; peripheral nerves |
| Description | The results of 13 patients with end-to-side anastomosis of the axillary nerve to various donor nerves were presented. The results were evaluated by means of functional and electrophysiological methods following avulsion and subsequent reconstruction of the brachial plexus. End-to-side anastomosis of the rat musculocutaneus nerve (n=12) with the ulnar one was used in the experimental model. The retrograde tracers were applied to prove the reinnervation. Fair and good results were achieved in neurotization of the axillary nerve in 75% of patients with follow up longer than 24 months. Electrophysiology proved reinnervation in 100% of the patients. The average muscle strength, according to the muscle test, was 3.80. The functional recovery started within 7-12 months postoperatively. Retrograde staining in the experimental model demonstrated the reinnervation of the rat biceps muscles 3 months from end-to-side anastomosis, mainly by collateral reinnervation from the ulnar nerve. The ulnar nerve motoneurons (70ą13) were able to send off collateral sprouts from their intact axons into the musculocutaneus nerve. Other motoneurons of the same pool (21ą4) regenerated axons directly into the musculocutaneus nerve without collateral sprouting, probably due to the axonotmesis of the motor fibers during the preparation of perineurial window. Our results demonstrated that end-to-side anastomosis of the peripheral nerve might be successfully used for reinnervation procedures of brachial plexus injury, mainly in the cases with insufficient sources of motor nerve fibers from neighboring intact motor nerves. |
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