Neural Regeneration Research ›› 2017, Vol. 12 ›› Issue (10): 1703-1707.doi: 10.4103/1673-5374.217350

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End-to-side neurorrhaphy repairs peripheral nerve injury: sensory nerve induces motor nerve regeneration

Qing Yu1, She-hong Zhang2, Tao Wang1, Feng Peng1, Dong Han1, Yu-dong Gu1   

  1. 1 Department of Hand Surgery, Huashan Hospital of Fudan University, Key Laboratory of Hand Reconstruction, the Ministry of Health, Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
    2 Department of Rehabilitation Medicine, Huashan Hospital of Fudan University, Shanghai, China
  • Received:2017-09-17 Online:2017-10-15 Published:2017-10-15
  • Contact: Yu-dong Gu,yudonggu@hotmail.com.

Abstract:

End-to-side neurorrhaphy is an option in the treatment of the long segment defects of a nerve. It involves suturing the distal stump of the disconnected nerve (recipient nerve) to the side of the intimate adjacent nerve (donor nerve). However, the motor-sensory specificity after end-to-side neurorrhaphy remains unclear. This study sought to evaluate whether cutaneous sensory nerve regeneration induces motor nerves after end-to-side neurorrhaphy. Thirty rats were randomized into three groups: (1) end-to-side neurorrhaphy using the ulnar nerve (mixed sensory and motor) as the donor nerve and the cutaneous antebrachii medialis nerve as the recipient nerve; (2) the sham group: ulnar nerve and cutaneous antebrachii medialis nerve were just exposed; and (3) the transected nerve group: cutaneous antebrachii medialis nerve was transected and the stumps were turned over and tied. At 5 months, acetylcholinesterase staining results showed that 34% ± 16% of the myelinated axons were stained in the end-to-side group, and none of the myelinated axons were stained in either the sham or transected nerve groups. Retrograde fluorescent tracing of spinal motor neurons and dorsal root ganglion showed the proportion of motor neurons from the cutaneous antebrachii medialis nerve of the end-to-side group was 21% ± 5%. In contrast, no motor neurons from the cutaneous antebrachii medialis nerve of the sham group and transected nerve group were found in the spinal cord segment. These results confirmed that motor neuron regeneration occurred after cutaneous nerve end-to-side neurorrhaphy.

Key words: nerve regeneration, peripheral nerve injury, end-to-side neurorrhaphy, motor-sensory specificity, rat, dorsal root ganglion, motor neuron, axon, cutaneous antebrachii medialis nerve, ulnar nerve, acetylcholinesterase staining, retrograde neuron tracing, neural regeneration