Suture Of Sciatic Nerve Research Articles

Ultrastructural changes of injured sciatic nerve after neurosurgical reconstruction and long-term electrostimulation in rabbits

Peripheral nerve injury is an extremely important problem during the war in Ukraine. In the overall pattern of injury, 5% of patients have peripheral nerve injuries and 1% have brachial plexus injuries. Under conditions of hostilities, this indicator increases to 70% or more. The victims are mainly young people of working age, which indicates the great medical and socio-economic significance of the problem. Materials and methods. The study was conducted on 28 rabbits Group 1 (n=7): suture of the sciatic nerve and implantation of the non-working antenna of the electrical stimulation device. Group 2 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation on the 2nd day. Group 3 (n=7): sciatic nerve suture + implantation of an electric stimulator antenna in the same route as in group 1 and the beginning of stimulation 3 weeks after operation, when the first signs of regeneration occurred. Group 4 (n=7): autograft of the sciatic nerve + implantation of an electric stimulator antenna and the beginning of stimulation at a time point that will coincide with the beginning of signs of reinnervation of the effector muscle. Сontrol of regeneration was carried out in 12 weeks. The axial cylinder (AC) diameter, myelin thickness (MS) and MS/AC ratio were analyzed using electron mycroscopy. Results. It was showed a statistically significant increase of AC and MS indicators in the study group 2 relatively to comparison group 1, respectively, by 1.8 and 1.75 times. The increase of AC and MS in group 2, relatively to the comparison group and a visual decrease at the ultrastructural level of the number of destructively changed myelin sheaths (strengthening of reparative and regenerative processes) were detected. Conclusion. Therefore, long-term invasive electrostimulation of the damaged peripheral nerve has a positive effect on the regeneration of the neuromuscular complex.

Experimental Study of the Bone Marrow Aspirate Injection Effect into Denervated Muscle (Clinical Manifestations of Limb Denervation)

Relevance. Peripheral nerve injuries are potentially disabling lesions, which account for about 2-3% of all injuries. In order to study the clinical manifestations of limb denervation in the early and late stages, we conducted an experimental study.
 Objective: in the experiment, to study the effect of bone marrow aspirate injection into the target muscles on denervation-reinnervation processes by studying the clinical manifestations of denervation (presence of trophic ulcers, edema, or muscle wasting).
 Materials and Methods. The experiment was performed on 36 rabbits, which were divided into four groups: a group of pseudo-operated animals, group 1 (neurotomy and sciatic nerve suture), group 2 (on-time injection of bone marrow aspirate), and group 3 (delayed injection of bone marrow aspirate). Detection of hypotrophy or edema of the tibia was performed by determining the percentage of leg circumference of the operated on and intact limbs. Clinical manifestations of limb denervation were recorded during the examination of experimental animals before their euthanasia.
 Results. When comparing the number of complications in group 1 and group 2, more complications of the denervation process was observed in group 1. At the same time, no difference was found between group 1 and group 3, as well as between group 2 and group 3. When comparing the indicators of hypotrophy, the difference between group 1 and group 2, as well as a significant difference (p<0.05) between group 1 and group 3, with a predominance of hypotrophy in group 2 and group 3 were revealed.
 Conclusions. The injection of bone marrow aspirate into the target muscles during surgery and in the early stages of reinnervation helped to reduce the clinical manifestations of the denervation process. Delayed administration of bone marrow aspirate to target muscles significantly (p<0.05) helped to reduce edema of denervated target muscles.

Study of the Effect of Bone Marrow Aspirate on Denervated Muscle According to CT and MRI Studies

Summary. Relevance. Peripheral nerve injury leads to severe limb dysfunction due to denervation, hypotrophy, and skeletal muscle degeneration. Non-invasive visualization methods of these changes are sonography, CT, and MRI.
 Objective: to study in the experiment the effect of bone marrow aspirate on the course of denervation and reinnervation processes in skeletal muscles using CT and MRI.
 Materials and Methods. The experiment was performed on 36 rabbits, which are divided into four groups: a group of pseudooperated animals, group 1 (neurotomy and sciatic nerve suture), group 2 (on-time injection of bone marrow aspirate), and group 3 (delayed injection of bone marrow aspirate). CT was performed on a Philips Brilliance 16; MRI was performed on a Philips Achieva 1.5 Tesla.
 Results. The study results of pseudooperated animals did not differ from the norm. There was a significant (p<0.05) difference in X-ray density between the target muscles of the operated and non-operated limb. The overall larger cross-sectional area of the target muscles was noted in group 2 (median 1.15 cm2), slightly smaller in group 1 (1.1 cm2), and the smallest in group 3 (1.0 cm2). The total X-ray density of the target muscles also differed, with the highest in group 1 (median 69.21 HU), less in group 2 (67.66 HU), and the lowest in group 3 (66.82 HU). We found a significant (p<0.05) difference between the MR signal strength of the target muscles in the T1 mode between groups 1 and 2.
 Conclusions. Bone marrow aspirate injection into the target muscles helps reducing muscle swelling. The intensity of the MR signal expression in the T1 mode in the group where the bone marrow aspirate injection was not performed was significantly (p<0.05) greater than in the groups with aspirate injection. The time of bone marrow aspirate injection to the target muscles did not significantly affect the parameters of CT and MRI signal.

Three microsurgical courses in Catania.

The utilization of microsurgical techniques in the surgical disciplines is now accepted worldwide, and many surgeons should receive the opportunity of learning these techniques. To meet this requirement, microsurgical courses have been organized and comprise both theoretical aspects and, especially, practical demonstrations. A one-week course usually allows attending surgeons to get familiar with magnification and to perform microvascular anastomoses, vasovasostomy, tubal reconstruction, sciatic nerve suture, and end-to-side portacaval shunt, a useful exercise before dealing with rodent organ transplantation. It is important to underline that the skill supplied by these microsurgical courses is not enough to start clinical applications of microsurgery; to this end, training must continue long after the course has been finished.

Atrophy and Regeneration of the Gastrocnemius-Soleus Muscles: Effects of Physical Therapy in the Monkey Following Section and Suture of Sciatic Nerve

The treatment of paralyzed muscles of the flaccid type has been based chiefly on clinical experience. The measures commonly employed are electrical stimulation, massage and passive movement, heat, rest and muscle reeducation. The exact indications for the use of these procedures alone or in combination, however, are still a subject of controversy. Thus, in the treatment of poliomyelitis many clinicians claim that electrical stimulation is contraindicated especially in the early stage of paralysis. They advocate rest. Others stressing the rapid rate of atrophy and degeneration maintain that something should be done to prevent, so far as possible, the progress of atrophy and fibrosis. They decry rest and advocate light massage and passive movement to be followed later by electrical stimulation. A review of the literature reveals considerable confusion and disagreement regarding the value of these measures, with their indications and contraindications. In view of the need for more precise knowledge

Suture of sciatic nerve

Suture of sciatic nerve

Suture of sciatic nerve

Suture of sciatic nerve