The 2004 Annual Meeting (January 14-20, 2004) of OASYS_NEW

Not yet assigned to a slot - 12:40 AM

Functional Recovery Following Complete Neurectomy, Partial Neurectomy and Nerve Crush

Kerns JM1, Malushte TS1, Huang C1, Safanda J2, and Gonzalez M3. (1) Anatomy and Cell Biology, Rush Medical College, 600 S. Paulina Ave, Chicago, IL, USA, (2) Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA, (3) Orthopedic Surgery, University of Illinois at Chicago, Cook County Hospital, 901 s Wolcott, Chicago, IL, USA

Peripheral nerve injuries are diverse in nature, lead to various degrees of disruption to the nerve architecture, and present a challenging problem for surgical repair. Compression, gunshot wound, contusion or stretch commonly results in a partial nerve lesion. In this experimental study, we examined the functional recovery following a novel partial lesion in comparison to more conventional crush and neurectomy lesions. We utilized walking track analysis (tibial functional index, TFI) as a non-invasive, clinically relevant technique to assess locomotor behavior before and after surgery. Secondly, the gastrocnemius wet muscle weight provided an indication of denervation atrophy. Rats (female, Fisher 344) rats were anaesthetized for surgery with random assignment to one of three groups: A- Partial lesion (n=10); B-Crush lesion (n=10); and C- Neurectomy (n=10). In group A, a partial lesion was created by resecting a 3mm section involving half the thickness of the left tibial nerve. The next two groups were positive and negative controls, respectively. In group B, the tibial nerve was crushed for two 30 second intervals using a Dumont forceps. In group C, the tibial nerve was transected and 10mm distal segment was removed. Walking tracks were obtained in a blinded manner before surgery and weekly for 9 weeks following surgery. At the time of euthanasia, the gastrocnemius muscle was isolated and dissected from each leg and weighed while wet. Walking track analysis indicated that the functional loss at one week following lesion was nearly complete in all three groups. The partial lesion showed gradual improvement during the next three weeks and plateaued at 7 weeks post-lesion (TFI = -42.6 +/-11.0). The crush lesion showed rapid and steady improvement with complete functional recovery at 4 weeks post-lesion (TFI = -8.8 +/-6.4). The neurectomy lesion showed no recovery for the entire nine weeks of the experiment (TFI = -89.6 +/- 10.7). The mean gastrocnemius wet muscle weight data showed a similar trend. The ratios (lesion:control) were 0.63, 0.87 and 0.32 for partial , crush and neurectomy lesions, respectively. The Pearson correlation coefficient for the TFI vs. muscle ratio (R2 = 0.89; p< 0.001) indicates that these two measures have a strong positive linear correlation. In conclusion, these functional results are consistent with the hypothesis that this novel partial nerve injury shows an intermediate functional recovery, as compared to crush or neurectomy. Supported in part by Rush- Cook County Collaborative Research Fund