Latero-terminal neurorrhaphy without removal of the epineural sheath. Experimental study in rats.

Revista paulista de medicina Pub Date : 1992-11-01
F Viterbo, J C Trindade, K Hoshino, A Mazzoni Neto
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Abstract

Termino-lateral neurorrhaphies have been used up to the beginning of this century. After this period, they have no longer been reported. We tested the efficacy of a new type of latero-terminal neurorrhaphy and evaluated the role of the epineural sheath. A group of 10 rats had the fibular nerve sectioned and the distal ending was sutured to the lateral face of the tibial nerve without removing the epineurium. All experiments were made on the right side, the left one remaining untouched in half of the animals of each group. The other half were denervated by sectioning and inverting the endings of the fibular nerves. In this way, tibial cranial muscles were either normal or denervated in the left side and reinnervated through latero-terminal neurorrhaphy in the right side. After 7.7 months, the animals were subjected to electrophysiological tests, sacrificed, and the nerves and muscles were taken for histological exams. A response of the tibial cranial muscle was obtained in 75% of the animals. The distal ending of the fibular nerve showed an average of 498 nerve fibers. The average areas of the reinnervated tibial cranial muscles were (mu 2):841.30 for M2n and 1798.33 for M2d. We concluded that the termino-lateral neurorrhaphy was functional, conducting electrical stimuli and allowing the passage of axons from the lateral surface of a healthy nerve, to reconstitute the distal segment of a sectioned nerve. The presence of the epineurium was no impediment to axonal regeneration or to the passage of electrical stimuli.(ABSTRACT TRUNCATED AT 250 WORDS)

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不切除神经外鞘的后端神经缝合术。大鼠实验研究。
末梢外侧神经吻合术一直应用到本世纪初。在这段时间之后,它们就不再被报道了。我们测试了一种新型后端神经缝合术的疗效,并评估了神经外鞘的作用。10只大鼠切除腓骨神经,将远端与胫神经外侧面缝合,不切除神经外膜。所有的实验都是在右侧进行的,每组中有一半的动物没有动过左侧的实验。另一半通过腓骨神经末梢的切开和倒置去神经。通过这种方法,左侧胫骨颅肌正常或去神经支配,右侧胫骨颅肌通过后端神经缝合再神经支配。7.7个月后,对大鼠进行电生理试验,处死,并对神经和肌肉进行组织学检查。75%的动物胫骨颅肌有反应。腓骨神经远端平均有498根神经纤维。再神经支配胫骨颅肌平均面积为(mu 2): M2n为841.30,M2d为1798.33。我们的结论是,末梢-外侧神经缝合术是功能性的,可以传导电刺激,并允许轴突从健康神经的外侧表面通过,重建被切断的神经的远端段。神经外膜的存在对轴突再生或电刺激的通过没有阻碍。(摘要删节250字)
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