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Experimental interfascicular nerve grafting.

B R Bratton, D G Kline, W Coleman

    Journal of Neurosurgery
    |September 1, 1979
    PubMed
    Summary
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    Autogenous interfascicular nerve grafts showed no advantage over direct end-to-end repair in rhesus monkeys. Short nerve grafts are feasible when direct repair is not possible, yielding comparable results by 12 months.

    Area of Science:

    • Neurosurgery
    • Regenerative Medicine
    • Peripheral Nerve Repair

    Background:

    • Peripheral nerve injuries require effective surgical repair strategies.
    • Autogenous nerve grafts are a common method for bridging nerve gaps, but their superiority over direct repair is debated.

    Purpose of the Study:

    • To compare the efficacy of autogenous interfascicular nerve grafts versus non-graft repairs for tibial nerve injuries in adult rhesus monkeys.
    • To evaluate the functional and histological outcomes of different nerve repair techniques over time.

    Main Methods:

    • Tibial nerves in 29 rhesus monkeys were completely lacerated and repaired using interfascicular grafts or direct end-to-end repair.
    • Functional recovery was assessed via electrophysiological recordings (nerve/muscle action potentials, muscle strength) at 4, 6, 9, and 12 months post-surgery.

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  • Histological examination using light and electron microscopy was performed on all repaired nerves.

    • Main Results:

    • Non-graft repairs demonstrated superior muscle strength at 4 and 6 months post-injury.
    • By 9 and 12 months, nerve graft repairs achieved functional recovery comparable to non-graft repairs.
    • Histological analysis revealed some axonal misdirection into connective tissues but sufficient regeneration through short grafts.

    Conclusions:

    • Autogenous interfascicular nerve grafts do not offer a significant advantage over direct end-to-end non-graft repair for tibial nerve injuries.
    • Short interfascicular nerve grafts are a viable option when direct end-to-end repair is not achievable, providing successful regeneration.