The comparative study of different nerve reconstruction for curing the brachial plexus root injury with wrist and finger drop / 中华显微外科杂志

ABSTRACT

ObjectiveTo evaluate the influence of different surgical technique on the pup and　adult rats after the rupture of upper trunk and middle trunk so as to find the best way of surgical therapy.MethodsFrom January 2010 to June of 2010, forty-eight Sprague-Dawley male rats were divided into two　groups of 24 each, i.e., pup groups at the age of 7 days postnatal (P7)and one adult (3 months old)group.After C5-7 injured,each group was subdivided into three equallygroup A (repair C5-7),B(repair C5,6),and C (no reinnervation performed).In the 3rd month postoperatively,the following tests were performed to estimate the recovery of each group(1)Compared the rate of carpoptosis of each group.(2)Compared the regenerated nerve traversing rate of the radial nerve in each group.(3)HE stain to compared the cross-sectional area recovery rate.(4)The MyoD1 and Myogenin of the affected extensor of forearm were measured by Western blot.Results(1) The ethology testthere were no carpoptosis in group of adult A and pup A; the carpoptosis rate of pup B and pup C were higher than that of adult A(P ＜ 0.05) ;the carpoptosis rate of pup A was lower than that of B and C(P ＜ 0.05); there was no difference between carpoptosis rate of adult A and B,but they were both lower than C(P ＜ 0.05).(2) Histological test of radial nervesThe percentage of myelinated both higher than C (P ＜ 0.05).(3) Western blotThe protein level of MyoD1 and Myogenin in radial nerve fiber in experimental side of pup A,B and C descended progressively (P ＜ 0.05).There was no difference between adult A and B,but they were both higher than C (P ＜ 0.05).(4) Histological test of the extensor digitoriumThere was no difference between cross-sectional area recovery rate of adult A and B,but they were pup A,B and C increased progressively (P ＜ 0.05).There was no difference between protein level of MyoD1 and Myogenin in adult A and B,but they were both lower than C (P ＜ 0.05),ConclusionIn adult rats, there is no difference between the recovery of wrist extensor of the two surgical procedure after the C5-7 injured. The restoration of C5-7 but not C5,6 can do more good to the recovery of wrist extensor in pup rats.It's important to repaire the C7 by nerve graft after injury of C5-7 in newborn.