Abstract
Background
Delayed reinnervation of denervated motor neuron has irreversible consequences. We introduced distal motor to distal sensory anastomosis (DDSA) as a practical, time-saving method to protect injured motor neurons and its target tissues.
Methods
Two experimental groups of Wistar rats were studied. In DDSA group, the distal end of the tibial sensory nerve of the left leg was anastomosed to the distal common peroneal nerve. The same nerves were dissected without anastomosis in the control group. Four months later, visual functional assessment of sciatic nerves was performed, and histological structures of the nerves and muscles and ultra-structure of nerves were evaluated.
Results
Significant enhancement was seen in intermediate toe spread factor in DDSA group (P < 0.05), but toe spread factor and subsequently sciatic statistic index demonstrated no significant improvement. The surgical procedures resulted in an ipsilateral rehabilitation in DDSA group with statistically significant (P < 0.05) improvement in muscle weight and myelinated axon count. Light and electron microscopy evaluations of the histological specimen showed obvious prevention of nerve and muscle tissues degeneration following anastomosis.
Conclusions
Overall, DDSA showed a peripheral nerve could repair, survive, and protect target tissues from degeneration without connection to their cell bodies and central nervous system. Some possible explanations for these positive results could be the restorative role of electrochemical signaling directly from the skin sensory nerve receptors and stimulation of Schwann cell to convert to its regenerative phenotype.
Level of Evidence: Not ratable.
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Acknowledgements
We would like to express our sincere gratitude to Mr. Pouyan Shaker for his help in editing the final draft of this article.
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This study was funded by Shahid Beheshti University of Medical Sciences (no grant number).
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Mohammad Ali Hosseinian, Sadegh Shirian, Ali Gharibi Loron, Abdul Ali Ebrahimy, Gholam Hossein Hayatolah declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving animals were in accordance with the ethical standards of the institutional animal ethics committee of the Shahid Beheshti University of Medical Sciences.
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Hosseinian, M.A., Shirian, S., Loron, A.G. et al. Distal sensory to distal motor nerve anastomosis can protect lower extremity muscle atrophy in a murine model. Eur J Plast Surg 41, 9–14 (2018). https://doi.org/10.1007/s00238-017-1313-z
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DOI: https://doi.org/10.1007/s00238-017-1313-z