The effect of bonemarrow puncture on the sciatic nerve injury repair (experimental study).

Abstract

Background. Problem of poor recovery efficiency of the damaged peripheral nerve is associated with prolonged nerve fiber regeneration and late reinnervation. Use of autologous bone marrow punctate is suggested for trophic support and stimulation of distal nerve in the path of nerve fiber sprouting. Objective. Investigate the effect of bone marrow aspirate on regeneration of the damaged sciatic nerve with simultaneous and delayed injection. Methods. Complete neurotomy and two end-to-end nerve sutures were applied and modeled on rabbit model. In group 1, only the nerve suture, in group 2, autologous bone marrow punctate was additionally administered, in group 3, punctate was injected 7 weeks afternerve suture. Histological and morphometric methods evaluated nerve regeneration at the level of nerve suture and 5-6 cm at 8, 12 and 18 weeks after surgery. Results. In group 1, 2 and 3 after 8 weeks nerve in the distal segment was recovered at the level of 20.8%, 33.3% and 41.6%; in 12 weeks - 41,6%, 72,9% and 75,0%; after 18 weeks - 47.9%, 77.1% and 72.9%. Regeneration significantly increased in the period 8-18 weeks in the nerves of group 1, and in groups 2 and 3 recovery was significantly faster, but the density of nerve fibers did not reach the values in the nerves of pseudoperated animals. Conclusions. The use of autologous bone marrow punctate stimulates regeneration of the surgically restored sciatic nerve, increasing density of nerve fiber regeneration and their myelination. Introduction of punctate immediately after the injury stimulates the recovery process to a greater extent than the delayed injection, but the difference is detected only in early stages of recovery.