Abstract
This preliminary research determines whether a combination of reverse end-to-side neurorrhaphy and rapamycin treatment achieves a better functional outcome than a single application after prolonged peripheral nerve injury. We found that the tibial nerve function of the reverse end-to-side + rapamycin group recovered better, with a higher tibial function index value, higher amplitude recovery rate, and shorter latency delay rate (P < 0.05). The reverse end-to-side + rapamycin group better protected the gastrocnemius muscle with more forceful contractility, tetanic tension, and a higher myofibril cross-sectional area (P < 0.05). Combining reverse end-to-side neurorrhaphy with rapamycin treatment is a practical approach to promoting the recovery of chronically denervated muscle atrophy after peripheral nerve injury.
Highlights
Peripheral nerve injury frequently leads to poor functional recovery, when nerve regeneration is adjourned and/or the injury is far from the target organ [1, 2]
We have previously proven that the reverse end-to-side neurorrhaphy technique prevented denervated muscle atrophy and improved the functional outcome [13,14,15]
We proved that the combination of reverse end-to-side (RETS) and rapamycin treatment achieved better functional results concerning the chronic denervation model of rats than the single application
Summary
Peripheral nerve injury frequently leads to poor functional recovery, when nerve regeneration is adjourned and/or the injury is far from the target organ [1, 2]. One solution is the early nerve protection technique for the denervated muscle, namely the traditional end-to-side (ETS) neurorrhaphy technique This technique consists of transecting the distal stump and suturing on an adjacent nerve in end-to-side form. The ETS neurorrhaphy is transected, and the distal stump is sutured to the proximal stump in an end-to-end fashion after the proximal stump reaches the distal stump [7,8,9,10,11] These methods can provide innervation for the target muscle before the original axon reaches the distal nerve stump, the stumps undergo Waller degeneration twice before reinnervation by the natural axon, which adversely affects axon regeneration and functional recovery [12]. Previous studies have shown that the RETS technique effectively prevented denervated muscle atrophy and significantly improved the functional outcome in rats [13,14,15]
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