Journal
NEUROSURGERY
Volume 63, Issue 1, Pages 144-153Publisher
OXFORD UNIV PRESS INC
DOI: 10.1227/01.NEU.0000335081.47352.78
Keywords
axon targeting; double labeling; misdirection; peripheral nerve regeneration; rat sciatic nerve model; retrograde tracing
Categories
Funding
- Mayo Clinic Department of Neurosurgery
- Netherlands (VSB Fonds, Leids Universitair Fonds, Janneke Fruin-Helb beurs, Stichting Fundatie van de Vrijvrouwe van Renswounde te's Gravenhage, Stichting Mitialto, Stichting Dr. Hendrik Muller's Vaderlandsch Foods, Lustra and Jo Keur Fonds)
- National Institutes of Health [EB02390]
- College of Medicine, Mayo Clinic
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OBJECTIVE: The accuracy of motor axon regeneration becomes an important issue in the development of a nerve tube for motor nerve repair. Dispersion of regeneration across the nerve tube may lead to misdirection and polyinnervation. In this study, we present a series of methods to investigate the accuracy of regeneration, which we used to compare regeneration across autografts and single-lumen poly(lactic-co-glycolic acid) (PLGA) nerve tubes. We also present the concept of the multichannel nerve tube that may limit dispersion by separately guiding groups of regenerating axons. METHODS: The simultaneous tracing of the tibial and peroneal nerves with fast blue and diamidino yellow was performed 8 weeks after the repair of a 1-cm nerve gap in the rat sciatic nerve to determine the percentage of double-projecting motoneurons. Sequential tracing of the peroneal nerve with diamidino yellow 1 week before repair and fast blue 8 weeks after repair was performed to determine the percentage of correctly directed peroneal motoneurons. RESULTS: In the cases in which there was successful regeneration across single-lumen nerve tubes, more motoneurons had double projections to both the tibial and peroneal nerve branches after single-lumen nerve tube repair (21.4%) than after autograft repair (5.9%). After multichannel nerve tube repair, this percentage was slightly reduced (16.9%), although not significantly. The direction of regeneration was nonspecific after all types of repair. CONCLUSION: Retrograde tracing techniques provide new insights into the process of regeneration across nerve tubes. The methods and data presented in this study can be used as a basis for the development of a nerve tube for motor nerve repair.
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