ABSTRACT
We employed 54 rats to devise a model of neuroma-in-continuity and explore the effect of the immunotoxin OX7-saporin on the neuroma. The left common peroneal, tibial or sciatic nerves were crushed by one 10-s application of a micro-artery forceps. At 3 and 6 weeks, the nerve was cut distal to the site of nerve crush, and retrograde fluorescent labeling was done. Pressure microinjection of 2 µl of natural saline or 2 µl of the immunotoxin conjugate OX7-saporin was done at the nerve stump 2 days later. Sacrifice was done after 3 weeks. In all control and saline-injection nerve specimens, gross observation and histology showed a neuroma-in-continuity. In 19 of the 24 OX7-saporin nerve specimens, gross observation showed a narrowed area at the site of nerve crush. Histology showed inhibition of neuroma-in-continuity formation. Fluorescent microscopy showed ablation of the labeled neurons in the dorsal root ganglia corresponding to the OX7-saporin subgroups.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Immunoconjugates/therapeutic use , Immunotoxins/therapeutic use , Peripheral Nerve Injuries/drug therapy , Ribosome Inactivating Proteins, Type 1/therapeutic use , Animals , Antibodies, Monoclonal/administration & dosage , Disease Models, Animal , Ganglia, Spinal/drug effects , Immunoconjugates/administration & dosage , Immunotoxins/administration & dosage , Male , Microinjections/methods , Microscopy, Fluorescence , Nerve Crush , Peripheral Nerve Injuries/pathology , Peroneal Nerve/injuries , Peroneal Nerve/pathology , Rats , Ribosome Inactivating Proteins, Type 1/administration & dosage , Saporins , Sciatic Nerve/injuries , Sciatic Nerve/pathology , Tibial Nerve/injuries , Tibial Nerve/pathologyABSTRACT
SUMMARY: A neuroma-in-continuity is a neuroma that results from failure of the regenerating nerve growth cone to reach peripheral targets. It occurs within an intact nerve in response to internally damaged fascicles, resulting in a distal portion of the nerve that no longer functions properly. Management of neuromas-in-continuity is challenging. Chemical methods, and microsurgical techniques including fascicular ligation, and burying into muscle and bone have been reported to prevent neuroma-in-continuity formation. The purpose of this article is to present novel techniques for neuroma-in-continuity management, and to discuss the related literature.
Subject(s)
Neuroma/therapy , Peripheral Nervous System Neoplasms/therapy , Animals , Humans , Immunotoxins/therapeutic use , Microsurgery/methods , Neuroma/etiology , Neurosurgical Procedures/methods , Neurotoxins/therapeutic use , Peripheral Nerve Injuries , Peripheral Nervous System Neoplasms/etiologyABSTRACT
This experimental study was performed to evaluate the efficacy of end-to-side coaptation between the musculocutaneous nerve and the phrenic nerve for brachial plexus injuries with nerve-root avulsions. In an experimental rabbit model, neurotization of the musculocutaneous nerve with the phrenic nerve was compared using end-to-end and end-to-side neurorrhaphy. Preliminary results from electrophysiologic and histologic examinations indicate that end-to-side neurotization of the musculocutaneous nerve with the phrenic nerve is an effective means for musculocutaneous nerve repair. The effectiveness of the phrenic nerve is attributed to its large number of motor axons.
