Limb Muscle Reinnervation with the Nerve-Muscle-Endplate Grafting Technique: An Anatomical Feasibility Study.

IF 1.7 Q4 NEUROSCIENCES
Neurology Research International Pub Date : 2021-12-08 eCollection Date: 2021-01-01 DOI:10.1155/2021/6009342
Liancai Mu, Jingming Chen, Jing Li, Stanislaw Sobotka, Themba Nyirenda
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引用次数: 2

Abstract

Background: Peroneal nerve injuries results in tibialis anterior (TA) muscle paralysis. TA paralysis could cause "foot drop," a disabling condition that can make walking difficult. As current treatment methods result in poor functional recovery, novel treatment approaches need to be studied. The aim of this study was to explore anatomical feasibility of limb reinnervation with our recently developed nerve-muscle-endplate grafting (NMEG) in the native motor zone (NMZ).

Methods: As the NMEG-NMZ technique involves in nerves and motor endplates (MEPs), the nerve supply patterns and locations of the MEP bands within the gastrocnemius (GM) and TA muscles of rats were investigated using Sihler's stain and whole-mount acetylcholinesterase (AChE) staining, respectively. Five adult rats underwent TA nerve transaction. The denervated TA was reinnervated by transferring an NMEG pedicle from the ipsilateral lateral GM. At the end of a 3-month recovery period, maximal muscle force was measured to document functional recovery.

Results: The results showed that the TA was innervated by the deep peroneal nerve. A single MEP band was located obliquely in the middle of the TA. The GM was composed of two neuromuscular compartments, lateral (GM-l) and medial (GM-m), each of which was innervated by a separate nerve branch derived from the tibial nerve and had a vertically positioned MEP band. The locations of MEP bands in the GM and TA muscles and nerve supply patterns demonstrated that an NMEG pedicle can be harvested from the GM-l and implanted into the NMZ within the TA muscle. The NMEG-NMZ pilot study showed that this technique resulted in optimal muscle force recovery.

Conclusion: NMEG-NMZ surgery is feasible for limb reinnervation. Specifically, the denervated TA caused by peroneal nerve injuries can be reinnervated with a NMEG from the GM-l.

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采用神经-肌肉-终板移植技术进行肢体肌肉神经移植的解剖学可行性研究。
背景:腓神经损伤导致胫前肌麻痹。TA瘫痪可能导致“脚下垂”,这是一种使行走困难的致残性疾病。由于目前的治疗方法导致功能恢复不佳,需要研究新的治疗方法。本研究的目的是探索我们最近开发的在自然运动区(NMZ)进行神经肌肉终板移植(NMEG)的肢体神经再支配的解剖学可行性。方法:由于NMEG-NMZ技术涉及神经和运动终板(MEP),分别用Sihler染色和乙酰胆碱酯酶(AChE)染色研究了大鼠腓肠肌(GM)和TA肌内MEP带的神经供应模式和位置。5只成年大鼠接受TA神经传导。通过从同侧GM转移NMEG椎弓根对失神经的TA进行神经再支配。在3个月的恢复期结束时,测量最大肌肉力量以记录功能恢复。结果:TA受腓深神经支配。一个单独的MEP带倾斜地位于TA的中间。GM由两个神经肌肉隔室组成,外侧(GM-l)和内侧(GM-m),每个隔室由源自胫骨神经的单独神经分支支配,并具有垂直定位的MEP带。MEP带在GM和TA肌肉中的位置和神经供应模式表明,NMEG椎弓根可以从GM-l获得并植入TA肌肉内的NMZ中。NMEG-NMZ的试点研究表明,这种技术可以实现最佳的肌肉力量恢复。结论:NMEG-NMZ手术治疗肢体神经再支配是可行的。具体来说,由腓神经损伤引起的失神经支配的TA可以用来自GM-1的NMEG进行神经再支配。
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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
10
审稿时长
17 weeks
期刊介绍: Neurology Research International is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focusing on diseases of the nervous system, as well as normal neurological functioning. The journal will consider basic, translational, and clinical research, including animal models and clinical trials.
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