Regenerative Strategies in Treatment of Peripheral Nerve Injuries in Different Animal Models

BACKGROUND@#Peripheral nerve damage mainly resulted from traumatic or infectious causes; the main signs of a damaged nerve are the loss of sensory and/or motor functions. The injured nerve has limited regenerative capacity and is recovered by the body itself, the recovery process depends on the severity of damage to the nerve, nowadays the use of stem cells is one of the new and advanced methods for treatment of these problems.METHOD: Following our review, data are collected from different databases ‘‘Google scholar, Springer, Elsevier, Egyptian Knowledge Bank, and PubMed’’ using different keywords such as Peripheral nerve damage, Radial Nerve, Sciatic Nerve, Animals, Nerve regeneration, and Stem cell to investigate the different methods taken in consideration for regeneration of PNI.RESULT: This review contains tables illustrating all forms and types of regenerative medicine used in treatment of peripheral nerve injuries (PNI) including different types of stem cells ‘‘ adipose-derived stem cells, bone marrow stem cells, Human umbilical cord stem cells, embryonic stem cells’’ and their effect on re-constitution and functional recovery of the damaged nerve which evaluated by physical, histological, Immuno-histochemical, biochemical evaluation, and the review illuminated the best regenerative strategies help in rapid peripheral nerve regeneration in different animal models included horse, dog, cat, sheep, monkey, pig, mice and rat. @*CONCLUSION@#Old surgical attempts such as neurorrhaphy, autogenic nerve transplantation, and Schwann cell implantation have a limited power of recovery in cases of large nerve defects. Stem cell therapy including mesenchymal stromal cells has a high potential differentiation capacity to renew and form a new nerve and also restore its function.

Posterior lumbar interbody fusion in treatment of lumbar spondylolithesis

This prospective study was conducted to evaluate the results of Posterior Lumbar Interbody Fusion in treatment of Lumbar Spondylolithesis. This study included 20 patients with Lumbar Spondylolithesis [9 Grade I, 8 Grade II and 3 Grade III]. All patients had low back pain and 17 of them had also associated radicular pain. There were 13 females and 7 males. The patients aged between 34 and 55 years with an average 37.5 years. Posterior Lumbar Interbody Fusion with two hallow threaded cylindrical cages filled with cancellous bone graft with the use of transpedicular screws fixation was done in all patients. All patients were followed up for east 2 years. Satisfactory osseous fusion was recorded in 17 patients [85%] after one year. Two patients had Satisfactory osseous fusion at the end of 2 years. Only one patient had no fusion at the end of the follow up. There was significant decrease in pain and significant functional improvement. There was no nerve root affection after operation. So we recommend the posterior Lumbar Interbody Fusion. In treatment of Lumbar Spondylolithesis to increase fusion rate, pain relief and functional improvement

Bipolar versus fixed head hip arthroplasty for femoral neck fractures in elderly patients

Between 2002 and 2006, fifty elderly patients with displaced femoral neck fractures were treated with hip replacement at Emergency Hospital Mansoura University. Patients were randomly selected with 25 patients had either cemented or cementless bipolar prosthesis and another 25 patients had either cemented or cementless fixed head prosthesis. There were 34 females and 16 males with an average age of 63.5 years [range between 55 - 72 years]. All patients were followed up both clinically and radiologically for an average follow up period 4.4 years [range between 2-6 years]. At the final follow up, the average Harris hip score among the bipolar group was 92 points [range between 72-97 points], while the fixed head group was 84 points [range between 65 - 95 points]. Radiologically, joint space narrowing more than 2 mm was found in only 8% [2 patients] among the bipolar group, and in 28% [7 patients] of the fixed head group. Through the follow up period, total hip replacement was needed in 2 cases of the bipolar group and 7 cases of the fixed head group. Bipolar hemiarthroplasty offer a better range of movement with less pain and more stability than the fixed head hemiarthroplasty in elderly patients with displaced femoral neck fractures regardless to the cost factor

Non operative treatment versus posterior fixation for thoracolumbar burst fractures without neurologic deficit

A Prospective study was conducted to compare the results of non operative treatment versus short- segment posterior fixation using pedicle screws for thoracolumbar burst fractures without neurologic deficit . This study involved 40 patients. Neurologically intact patients with single - level closed burst fracture involve T 11 - L2 were included in the study . Patients in the non operative group were allowed activity to the point of pain tolerance beginning on the day of injury using hyperextension brace . Patients in the operative group underwent two levels [one above and one below] fixation using transpedicuar screws. The follow up period was 1 year. The surgical group had less pain up to 3 months and a better outcome up to 6 months, but the outcome was similar afterward. No neurologic deficit developed in any patient . In the non operative group, the kyphosis angle worsened by 4o and retropulsion decreared from 35% to 15%. Short - segment posterior fixation provides partial kyphosis correction and earlier pain relief but functional outcome at 1 year is similar in both groups