Electroneuromyographic correlates of sciatic nerve function restoration after its resection and welded epineural coaptation in the experiment
Objective: To estimate the effectiveness of welding epineural coaptation of the residual sciatic nerve after resection based on electroneuromyographic (ENMG) parameters obtained in the gastrocnemius muscle.
Materials and methods. Experimental animals were albino outbreed male rats (350–450 g, 7 months old); trauma model was the resection of the left sciatic nerve in the middle third; the experimental groups were as following: 1 — neurotomy (n = 18), 2 — neurotomy + neurosuture (n = 13), 3 — neurotomy + welding coaptation (n = 15); the method of investigation was direct needle ENMG (sciatic nerve stimulation, responses were registered in gastrocnemius muscle) in 3 and 5 months after injury.
Results. The model of the nerve trauma with a temporary restriction of limb mobility is relevant for evaluating the effectiveness of restorative interventions in this type of pathology. In 5 months of observation there was found a significant prevalence of M-response amplitude in the injured limb compared to neurorrhaphy (17.3 ± 2.3 vs. 8.4 ± 0.9 mV, respectively; p = 0.005). M-response amplitude lateralization after the welded coaptation, in contrast to neurorrhaphy, is of temporary nature, indicating the improved regeneration process. Absence of ENMG-indices lateralization in 3 and 5 months after the neurotomy and high values of the M-response amplitude in 5 months indicated the possibility of gastrocnemius alternative re-innervations by terminals of intact nerve trunks.
Conclusion. High-frequency electric epineural welding provides a reliable coaptation of the residual nerve, and, taking into account some ENMG indicators, is more effective than neurorrhaphy.
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3. Scholz T, Krichevsky A, Sumarto A, Jaffurs D, Wirth G, Paydar K, Evans GR. Peripheral nerve injuries: an international survey of current treatments and future perspectives. J Reconstr Microsurg. 2009;25(6):339-44. [CrossRef] [PubMed]
4. Lad SP, Nathan JK, Schubert RD, Boakye M. Trends in median, ulnar, radial, and brachioplexus nerve injuries in the united states. Neurosurgery. 2010;66(5):953-60. [PubMed]
9. Rosberg HE, Carlsson KS, Hojgard S, Lindgren B, Lundborg G, Dahlin LB. Injury to the human median and ulnar nerves in the forearm — analysis of costs for treatment and rehabilitation of 69 patients in southern Sweden. J Hand Surg (Br). 2005;30(1):35-9. [CrossRef] [PubMed]
10. Castillo-Galvбn ML, Martнnez-Ruiz FM, de la Garza-Castro O, Elizondo-Omana RE, Guzmбn-Lуpez S. [Study of peripheral nerve injury in trauma patients]. Gac Med Mex. 2014;150(6):519-23. [PubMed]
11. Dalamagkas K, Tsintou M, Seifalian A. Advances in peripheral nervous system regenerative therapeutic strategies: A biomaterials approach. Mater Sci Eng C Mater Biol Appl. 2016;65:425-32. [CrossRef] [PubMed]
12. Tsymbaliuk VI, Luzan BM, Tsymbaliuk YaV. [Diagnostics and treatment of traumatic injuries of peripheral nerves in combat conditions]. Travma. 2015;16(3):13-8. Ukrainian.
13. Nakamura T, Inada Y, Fukuda S, Yoshitani M, Nakada A, Itoi S, Kanemaru S, Endo K, Shimizu Y. Experimental study on the regeneration of peripheral nerve gaps through polyglycolic acid-collagen (PGA-collagen) tube. Brain Res. 2004;1027(1-2):18-29. [CrossRef] [PubMed]
14. Lauto A, Mawad D, Foster LJR. Adhesive biomaterials for tissue reconstruction. J Chem Technol Biotechnol. 2008;83:464-72. [CrossRef]
16. Felix SP, Pereira Lopes FR, Marques SA, Martinez AMB. Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve. Microsurgery. 2013;33(6):468-77. [CrossRef] [PubMed]
18. Tsymbaliuk VI, Molotkovets VYu, Kvasha MS, Medvediev VV, Molotkovets KM, inventors; Romodanov Neurosurgery Institute, Kiev, Ukraine, assignee. Method of restoration spatial integrity of injured peripheral nerves mature male rats [Sposib vidnovlennya prostorovoyi tsilisnosti travmovanoho peryferychnoho nerva statevozrilykh shchuriv-samtsiv]. Ukraine Patent 101497. 2015 September 10. Ukrainian.
19. Paton BYe. [Welding and related technologies for medical applications]. Avtomaticheskaya Svarka (Automatic Welding). 2008;11(667):13-23. Russian.
24. De Francesco-Lisowitz A, Lindborg JA, Niemi JP, Zigmond RE. The neuroimmunology of degeneration and regeneration in the peripheral nervous system. Neuroscience. 2015;302:174-203. [CrossRef] [PubMed]
29. Badalyan LO, Skvortsov IA. Klinicheskaya electroneyromiografiya. [Clinical electroneuromyography]. Moskow: Meditsina; 1986. Russian.
30. Geht BM, Kasatkina LF, Samoylov MI, Sanadze AG. Electroneuromiografiya v diagnostike nervno-myshechnykh zabolevaniy [Electroneuromyography in diagnostics of neuro-muscular diseases]. Taganrog: TRTU; 1997. Russian.
31. Overgaard K, Nielsen OB, Flatman JA, Clausen T. Relations between excitability and contractility in rat soleus muscle: role of the Na–K pump and Na/K gradients. J Physiol. 1999;518(Pt.1):215-25. [CrossRef] [PubMed]
32. Scaglioni G, Narici MV, Maffiuletti NA, Pensini M, Martin A. Effect of ageing on the electrical and mechanical properties of human soleus motor units activated by the H reflex and M wave. J Physiol. 2003;548(Pt.2):649–61. [CrossRef] [PubMed]
33. Call JA, Warren GL, Verma M, Lowe DA. Acute failure of action potential conduction in mdx muscle reveals a new mechanism of contraction-induced force loss. J Physiol. 2013;591(15):3765–76. [CrossRef] [PubMed]
34. Tan AM, Chakrabarty S, Kimura H, Martin JH. Selective corticospinal tract injury in the rat induces primary afferent fiber sprouting in the spinal cord and hyperreflexia. J Neurosci. 2012;32(37):12896-908. [CrossRef] [PubMed]
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Copyright (c) 2017 Vitaliy I. Tsymbaliuk, Vitaliy Y. Molotkovets, Volodymyr V. Medvediev, Borys M. Luzan, Lesia S. Turuk, Мykhaylo М. Tatarchuk, Natalya G. Draguntsova
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