通过胶原管架桥使轴突从脊髓到神经根再生长的研究

Axonal regrowth through collagen guidance channel from spinal cord to nerve roots:experimental study in adult rats

目的 探讨用胶原管 (collagentube)架桥于脊髓前角与撕脱的脊神经根间 ,促使轴突再生长 ,以修复脊髓到周围神经的传导通道。方法 用大白鼠制成臂丛损伤模型 ,分为四组。A组用胶原管架桥连接脊髓前角与撕脱的神经根 ;B组把自体坐骨神经分支移植物放入到连接于脊髓前角与神经根的胶原管内 ;C组用一段周围神经移植物架桥在脊髓与撕脱的神经根之间 ;D组为仅作神经根撕脱的对照。结果 采用电生理学监测修复后肌肉的电生理活动及收缩功能 ,通过病理学及组化学 ,观察脊髓和神经元的轴突再生状况并作了移植物的形态学分析 ,证明大量的新生神经纤维经过移植物进入到被修复的神经根及其周围神经 ,并使神经组织和肌肉重新形成了运动终板 ,从而恢复了一定的肌肉收缩功能。结论 用胶原管架桥作CNS到PNS神经再连接 。

Objective To investigate axonal regrowth from cervical spinal cord to avulsed nerve roots through an implanted collagen guidance channel in adult rats after brachial plexus injuries.Methods Fifty four adult SD rats underwent avulsion of the right C5 7 nerve roots. Group A(n=15):a collagen guidance channel was used to bridge the cervical spinal cord and the disconnected C6 nerve root. Group B(n=15):after the same repair procedure as in group A, a segment nerve autograft was freely introduced into the collagen channel. Group C(n=15):a nerve autograft was used to bridge the cord and the root. Group D(n=9):no repair was performed after avulsion of the nerve roots.Results Nine months surgery, electrophysiology and histology showed that neuroanatomic and functional connection were restablished between the cervical spinal cord and the denervated target biceps through the repaired root pathway in all treated animals. After analyzing the data obtained, no significant difference was found between the treated groups (Group A,B and C).No evident regeneration and no functional recovery was detected in the control group D.Conclusion The collagen guidance channel can be used to reconnect the spinal cord and the disconnected nerve root after brachial plexus injury in adult rats. At least when short gaps are required, this kind of channel appears to act as effectively as a nerve autograft for promoting axonal regrowth.