脊髓损伤行神经根移位术改善机体功能的实验研究

An Experimental Study to improve Fermal Muscle Function by Nerve Root Transefer after Spinal Cord Injured in Rats

目的研究脊髓损伤后行神经根移位术对机体远端功能的改善情况。方法将40只Wistar大鼠随机分为两组,每组20只,切除L2段脊髓0.5cm。一周后切断右侧L1和L2神经根,其中实验组A组行神经根移位术即L1神经根近端和L2神经根远端吻合;对照组B组仅行L2神经根原位吻合。术后12周分别行神经肌电生理,组织学检查,肌肉湿重测定和辣根过氧化物酶(HRP)逆行示踪观察神经根移位术后神经元定位,纤维再生和肌肉萎缩情况。结果术后12周,A组右侧股四头肌失神经支配现象明显改善,股四头肌功能有所恢复,而B组无改善。结论神经根移位术能重建脊髓损伤后的反射和传导通路,从而恢复截瘫肢体的部分功能。

Objective To study the improvement of fermal muscle function after nerve root transefer in rats whose spinal cord were injured. Methods 40 Wistar rats were randomLy divided into two groups：group A and group B. The segment of L2 spinal cord of two groups were hemitransected leaving a 4 mm gap in the right. One week later,the right LI nerve roots and L2 nerve roots were cut off after spinal cord hemisection. The proximal site of ritht LI nerve root were sutured with the distal site of right 1,2 nerve root in group A. The right L2 nerve root of the group B were sutured only in situ. At 12th week after operation, spine and nerve function were evaluated by morphology, electrophysiology and horseradish peroxidase tracing. Results The improvement and recovery of the fermal muscle function were obvious in group A. In the meantime, the imopovement of group B did not be observed. Conclusion Nerve root transefer can rebuild the passway of the nerve refletion and transmission in rats whose spinal cord were injuried and restore the partial function of denervated fermal muscle.