Is Axonal Sprouting Able to Traverse the Conjunctival Layers of the Peripheral Nerve? A Behavioral, Motor, and Sensory Study of End-To-Side Nerve Anastomosis

Ja, Bertelli; Santos, Adair R.S.; Jb, Calixto

doi:10.1055/s-2007-1006630

Cited by 83 publications

(73 citation statements)

References 4 publications

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“…The fibrin glue, already used in the ETE [19][20][21][22][23] , can also be used in the ETS 4 . An important disadvantage of this method is it high cost 24 .…”

Section: Discussionmentioning

confidence: 99%

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The embracing end-to-side neurorrhaphy in rats

et al. 2012

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PURPOSE:Compare two new methods with the traditional end-to-side neurorrhaphy. METHODS: Rats were divided into four groups. In A-L group the peroneal nerve was sectioned and the distal stump was connected to the lateral of the tibial nerve (donor) with two 10-0 nylon points. In A-R group two perineurium flaps embraced the donor nerve. In the B-R group a suture embraced the donor nerve. Group B-L was the control. After six months tibial cranial muscle mass and morphometry of the distal stump of the peroneal nerve were evaluated. RESULTS:Muscle mass in groups A-R, A-L and B-R were lower than B-L group (p<0.0001) an equal between themselves (p>0.05).Groups A-R, B-R and A-L had a lower number of nerve fibers when compared with B-L (p=0.0155, p=0.016, p=0.0021). CONCLUSION:The three types of neurorrhaphy showed no differences related to muscle mass and number of nerve fibers suggesting that the embracing with a single suture has great potential due its simplicity and usefulness in deep areas. CONCLUSÃO: Os três tipos de neurorrafia não apresentaram diferenças relacionadas à massa muscular e número de fibras nervosas sugerindo que a sutura abraçante com apenas um ponto apresente grande potencial em áreas cirúrgicas mais profundas.Descritores: Neurorrafia término-lateral. Sutura abraçante. Ratos. The embracing end-to-side neurorrhaphy in rats

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“…The fibrin glue, already used in the ETE [19][20][21][22][23] , can also be used in the ETS 4 . An important disadvantage of this method is it high cost 24 .…”

Section: Discussionmentioning

confidence: 99%

“…Since Viterbo et al [1][2][3] introduced the End-to-Side Neurorraphy (ETS) concept without lesion in the donor nerve, many studies were published 4,5 .…”

Section: Introductionmentioning

confidence: 99%

The embracing end-to-side neurorrhaphy in rats

et al. 2012

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“…While most investigators believe that an epi-or perineurotomy is required for axons to sprout through an ETS nerve repair (Bertelli, et al 1996, Noah, et al 1997, others suggest that effective sensory axonal sprouting into the ETS repair occurs in the absence of any donor nerve injury. In this aforementioned study, a silicone Y-chamber that secured the donor and recipient limbs to one another facilitated sensory sprouting as attributed to the invasion of donor nerve epineurium with SCs (Matsumoto, et al 1999).…”

Section: Discussionmentioning

confidence: 99%

“…Some have suggested that collateral axonal sprouts repopulate the terminal limb without axotomy, attributing this spontaneous phenomenon to neurotrophic influences (Caplan, et al 1999,Thanos, et al 2001. Others suggest that an epineurotomy or perineurotomy, exposing but not injuring donor axons facilitates spontaneous collateral sprouting (Bertelli, et al 1996). Others show that regenerative sprouting induced by a deliberate axotomy is required to induce some terminal sprouts to regenerate down the recipient pathway rather than the original donor nerve pathway ).…”

Section: Introductionmentioning

confidence: 99%

Axotomy or compression is required for axonal sprouting following end-to-side neurorrhaphy

Hayashi

Pannucci

Moradzadeh³

et al. 2008

Experimental Neurology

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End-to-side (ETS) nerve repair remains an area of intense scrutiny for peripheral nerve surgeonscientists. In this technique, the transected end of an injured nerve, representing the "recipient" is sutured to the side of an uninjured "donor" nerve. Some work suggests that the recipient limb is repopulated with regenerating collateral axonal sprouts from the donor nerve that go on to form functional synapses. Significant, unresolved questions include whether the donor nerve needs to be injured to facilitate regeneration, and whether a single donor neuron is capable of projecting additional axons capable of differentially innervating disparate targets. We serially imaged living transgenic mice (n=66) expressing spectral variants of GFP in various neuronal subsets after undergoing previously described atraumatic, compressive, or epineurotomy forms of ETS repair (n=22 per group). To evaluate the source, and target innervation of these regenerating axons, nerve morphometry and retrograde labeling was further supplemented by confocal microscopy as well as Western blot analysis. Either compression or epineurotomy with inevitable axotomy were required to facilitate axonal regeneration into the recipient limb. Progressively more injurious models were associated with improved recipient nerve reinnervation (epineurotomy: 184±57.6 myelinated axons; compression: 78.9±13.8; atraumatic: 0), increased Schwann cell proliferation (epineurotomy: 72.2% increase; compression: 39% increase) and cAMP response-element binding protein expression at the expense of a net deficit in donor axon counts distal to the repair. These differences were manifest by 150 days, at which point quantitative evidence for pruning was obtained. We conclude that ETS repair relies upon injury to the donor nerve.

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“…One way is that the regenerative nerve derived from collateral sprouting from the intact donor nerve [53][54][55]. The other is that regenerated nerve derived from terminal sprouting of donor nerve due to the damage to the donor nerve during suturing process [56][57][58]. Zhang, et al [59] and Hayashi, et al [60] demonstrated that the nerve regeneration through the terminolateral neurorrhaphy originated from the collateral sprouting from the intact donor nerve by using immunofluorescence tracing technique.…”

Section: The Mechanism Of Nerve Regeneration Of Terminolateral Neurormentioning

confidence: 99%