自体周围神经组织游离移植治疗陈旧性脊髓损伤

The transplantation of peripheral nerve treat the later injury of spine cord

目的 为损伤的脊髓组织提供神经纤维、神经细胞及所含因子,以恢复其部分功能。方法 脊髓松解后,纵行切开适宜的长度、深度,将自身周围神经(一般为腓肠神经)用显微外科方法去除外膜、束膜,并剪开、截断部分神经纤维至其质地、外观类似马尾组织,将其呈多条状、纵行排列植入已切开的脊髓处。用8个0的无损伤线与硬膜适当固定,骶棘肌瓣覆盖。结果 6例患者经术后1/2～3年随访,按Frankel分级,功能恢复较术前增加两级以上的四例,一级以上的二例。结论 该方法可为损伤段脊髓提供良好的的神经生长环境和桥梁支架,有利于脊髓功能恢复。

Objective Supplying nerve fibres. nerve cells and factors included in them to spine cord improves the recovery of the function of the spine cord. Methods After releasing the spine cord,incises it vertically at the appropriate length and depth. One's own peripheral nerve (usually is sura nerve), which is removed its epineurium. nearilemma and incised it open and cut off a proportion of nerve fibres with microsurgery technique so that its character and appearance looks like cauda equine, is transplanted multi-striply, vertically inside the spine con! incised and fastens appropriately to dura mater with 8'0'nylon thread and covered with sacrospinal muscle flap. Results At 1/2-3 years follow up post-operation, according to classification of Frankel:4 cases recovered above 2 grade,2 cases recovered above 1 grade. Conclusion This method can supply good environment of nerve growth and function of bridge and plank to segment of injury spine cord. thus can accelerate the recovery of spine cord.