Neural Regeneration Research ›› 2017, Vol. 12 ›› Issue (12): 2077-2083.doi: 10.4103/1673-5374.221167

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Autologous transplantation with fewer fibers repairs large peripheral nerve defects

Jiu-xu Deng, Dian-yin Zhang, Ming Li, Jian Weng, Yu-hui Kou, Pei-xun Zhang, Na Han, Bo Chen, Xiao-feng Yin, Bao-guo Jiang   

  1. Department of Orthopedics and Trauma, Peking University People’s Hospital, Beijing, China
  • Received:2017-11-25 Online:2017-12-15 Published:2017-12-15
  • Contact: Xiao-feng Yin, M.D. or Bao-guo Jiang, M.D.,xiaofengyin@bjmu.edu.cn or jiangbaoguo@vip.sina.com.
  • Supported by:

    This study was supported by the National Basic Research Program of China (973 Program), No. 2014CB542200; a grant from the Ministry of Education Innovation Team, No. IRT1201; the National Natural Science Foundation of China, No. 31271284, 31171150, 81171146,30971526, 31100860, 31040043, 31640045, 31671246; a grant from the Educational Ministry New Century Excellent Talents Support Project in China, No. BMU20110270; a grant from the National Key Research and Development Program in China, No. 2016YFC1101604.

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Abstract:

Peripheral nerve injury is a serious disease and its repair is challenging. A cable-style autologous graft is the gold standard for repairing long peripheral nerve defects; however, ensuring that the minimum number of transplanted nerve attains maximum therapeutic effect remains poorly understood. In this study, a rat model of common peroneal nerve defect was established by resecting a 10-mm long right common peroneal nerve. Rats receiving transplantation of the common peroneal nerve in situ were designated as the in situ graft group. Ipsilateral sural nerves (10–30 mm long) were resected to establish the one sural nerve graft group, two sural nerves cable-style nerve graft group and three sural nerves cable-style nerve graft group. Each bundle of the peroneal nerve was 10 mm long. To reduce the barrier effect due to invasion by surrounding tissue and connective-tissue overgrowth between neural stumps, small gap sleeve suture was used in both proximal and distal terminals to allow repair of the injured common peroneal nerve. At three months postoperatively, recovery of nerve function and morphology was observed using osmium tetroxide staining and functional detection. The results showed that the number of regenerated nerve fibers, common peroneal nerve function index, motor nerve conduction velocity, recovery of myodynamia, and wet weight ratios of tibialis anterior muscle were not significantly different among the one sural nerve graft group, two sural nerves cable-style nerve graft group, and three sural nerves cable-style nerve graft group. These data suggest that the repair effect achieved using one sural nerve graft with a lower number of nerve fibers is the same as that achieved using the two sural nerves cable-style nerve graft and three sural nerves cable-style nerve graft. This indicates that according to the ‘multiple amplification’ phenomenon, one small nerve graft can provide a good therapeutic effect for a large peripheral nerve defect.

Key words: nerve regeneration, peripheral nerve injury, peripheral nerve defect, autologous nerve graft, functional recovery, nerve conduction velocity, sural nerve, common peroneal nerve, sleeve bridging suture, neural regeneration