Experimental Study of Nerve Regeneration by Inside-in and Inside-out Vein Graft in the Nerve Defect of Rat / 대한정형외과학회잡지

PURPOSE: Autogenous vein graft as an alternative to autogenous nerve graft for bridging the gap of the peripheral nerve has been widely accepted. The purpose of this study was to find the comparative superiority between the two grafting techniques of inside-in and inside-out vein graft in rat model. MATERIALS AND METHODS: Thirty-three Sprague-Dawley rats were divided into three experimental groups: inside-in vein graft (group A), inside-out vein graft (group B) and control group. In group A, 15 mm jugular vein was grafted to a 10 mm gap created in the sciatic nerve. In group B, the same procedure was performed with group A, however, the vein was pulled through itself and its normal orientation was inverted before grafting. To compare the results of the two groups, electromyography and histologic studies were performed at 4, 8 and 12 weeks postoperative. RESULTS: In the electromyographic study, the mean of peak amplitude of compound motor action potential in group B was significantly higher than in group A at each experimental week. In the light and electron microscopic study, group B had more abundant regenerated axons and myelinized axonal fibers than group A at 4 weeks. At 8 and 12 weeks, there were no significant differences in the numbers and extents of myelinization of regenerated axons in both groups. CONCLUSION: This study demonstrates that inside-out vein grafting technique induces more faster axonal regeneration and earlier reinnervation to the denervated distal muscles in rat model.

Spinal Stenosis in Paget's Disease: 1 Case Report / 대한정형외과학회잡지

In the paget's disease involving the vertebra, the symptom and sign of compression come from encroachment on the spinal cord due to the enlarging vertebral bodies, pedicles and laminae. The cord compression appears to be preceded by a long insidious period of noncharacteristic clinical symptoms with minor neurologic dysfunction. The lumbar syndrome of Paget's disease is classified according to its severity, clinical findings, biochemical factors and radiologic patterns. The severity of neurologic complication in Paget's disease involving the vertebra varies according to the level involved. The outcome depends on the suddeness of symptom onset and the effectiveness of decompression. We have experienced a case of Paget's disease involving long bones and lumbar spine in 56 year old male patient, in which surgical decompression produced improvement. We report a case of spinal stenosis in paget's disease with brief review of literature.