Ukrainian Neurosurgical Journal (Jun 2021)
Correlation analysis of electroneuromyographic, functional-anatomical and morphometric indicators of regeneration of the injured sciatic nerve
Abstract
Objective. To study the electrophysiological, functional-anatomical and morphometric indicators of the sciatic nerve regeneration after complete transection and connection of the nerve stumps with epineural sutures and adhesives. Materials and methods. The experiments were carried out on white outbred male rats. The efficiency of sciatic nerve regeneration was investigated with the standard 4-6 epineural sutures and the use of polyethylene glycol hydrogel Duraseal or Tisseel fibrin glue with 2 fixation sutures. On the 14th, 30th and 60th days after the complete transection of the sciatic nerve and subsequent connection of the nerve stumps with epineural sutures, hydrogel or fibrin glue, limb function was assessed using SFI test and ENMG. The distal segment of the nerve was sampled for electron microscopic and morphometric studies. The density of the regenerated myelinated nerve fibers was studied and a correlation analysis was performed with the results of SFI test and ENMG. Results. The use of adhesives provides a similar result of connecting the transected sciatic nerve, as in standard neurorrhaphy, and regeneration of myelinated nerve fibers in the distal nerve. The regeneration density of myelinated nerve fibers significantly increased on the 30 th and 60th days in the groups in which Duraseal hydrogel and Tisseel fibrin glue were used, without a statistically significant difference in ENMG parameters (M-response amplitude, nerve conduction velocity, latency period) and the result of SFI test. The amplitude of M-response on the 30th day was statistically significantly lower after the connection of nerve stumps with Tisseel fibrin glue in comparison with the Duraseal hydrogel, whereas on the 60th day there was no difference according to the results of electrophysiological studies. Conclusions. The efficiency of sciatic nerve regeneration after the combined connection exceeds the standard technique, and the results of pathophysiological assessments are more often correlated with morphometry data on the 30th day.