摘要
目的探讨臂丛神经根性撕脱后神经根再植入脊髓的可行性。方法采用大鼠颈_(5～7)神经根性撕脱伤实验动物模型,伤后将 C_(5～7)神经根即刻植入脊髓。分别于神经根植入后3周、3个月、6个月取材。应用组织病理活检、免疫组化技术及神经示踪技术,对神经中枢及吻合口下段神经干检查。观察脊髓前角运动神经元和神经元内尼氏体数目和形态的改变;周围神经纤维再生数目、距离,轴索和髓鞘发育情况。结果臂丛神经根性撕脱伤对动物生长和存活有较大的影响。脊髓前角运动神经元数目在3个月内持续减少,3个月后趋于稳定,6个月时脊髓前角大型运动细胞坏死比率在40%左右,残存的神经元多为受损的神经元,尼氏体减少或消失。脊髓前角运动神经元再生轴突可重新生长入周围神经干,再生神经纤维轴索较细,大部分髓鞘发育不完全,轴突再生距离较短,肌皮神经6个月内无神经纤维再生。结论臂丛神经根性撕脱伤,神经根回植入脊髓后,脊髓前角运动神经元坏死比率为40%左右,残存神经元多为受损神经元,再生神经纤维表现为动力不足和发育不全,对终末器官功能恢复没有意义。
Objective To investigate the feasibility of spinal nerve root reimplantation in brachial plexus root avulsion in a rat model. Methods Root avulsion of C5,6,7 was created in rats. The avulsed roots were reimplanted into the spinal cord innnediately after establishing the brachial plexus root avulsion model. At different postoperative intervals （3 weeks, 3 months, 6 months）, the spinal cord and distal nerve trunk were observed by means of pathological examination and innnunohistological techniques and nerve tracing techniques. Number and morphology of motor neurons of the anterior horn, number of distal regenerating axons, its extending distance and maturation were studied. Results Brachial plexus root avulsion had substantial influence on growth and survival of the animals. The number of spinal motoneurons continued to decline in the first 3 months postoperativdy and plateaued after three months. At 6 months about 40% of the large motoneurons at the anterior horn necrosed. The residual neurons were mostly pathologic, showing decreased or diminished Nissl bodies. Surviving motoneurons could regenerate axons into the trunk of distal peripheral nerve after root reimplantation. The regenerated axons were thin and with immature myelin sheath. Axon regenerating distance was very short, No regenerating axons were seen in the musculocutaneous nerve at six months of surgery. Conclusion Following brachial plexus root avulsion, the spinal motoneuron necrosis rate was as high as 40%. The residual neurons were mostly pathologic with poor regenerating capability. Therefore spinal nerve root reimplantation cannot lead to restoration of end organ function.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第4期241-244,共4页
Chinese Journal of Hand Surgery
基金
吉林省科技厅基金(200505232)
关键词
臂丛
神经损伤
运动神经元
回植
Brachial plexus
Nerve injuries
Motor neurons
Reimplantalion
