Computer-assisted Three-Dimensional Reconstruction Of Human Brachial Plexus From Serial Tissue Sections

Background: The nerve repair and regeneration after injury have always been a focus in the field of orthopedics. However, it is very difficult to improve the result of functional recovery. The main reason lies in the wrong anastomose of nerve fibers between sense and motor ones. The injury of brachial plexus is one of very common disease in orthopaedic clinic. It usually results to limb disability and severely affects the life quality of patient. And it is a very ideal condition to anastomose the same kinds of nerve fibers together that demand more précised study on the character and location of fascicular anatomy. So it is an urgent problem to précised show the complex three-dimensional structure of nerve fascicless and fibers inside the brachial plexus in this domain that the nerve bundles inside nerve trunk mix, intercross and merge one another in their function and character. Traditional nerve atlas obtained through gross anatomy and histological methods contains only two-dimensional information which can not show the real cross and recombination process of nerves bundles in its whole length. The report of three-dimensional reconstruction of microstructure inside human peripheral nerve has not been seen. The digital virtual human project has a very important sense. However, it is very difficult to reconstruct the three-dimensional structure of nerve system. So an effective method of catching nerve information is urgently demanded. Objective: To reconstruct the three-dimensional structure of human brachial plexus include its out contour and the ultra-complicated pathways of nerve fascicles inside and at the same time to study a useful and practical method for three-dimensional reconstruction of brachial plexus.Methods: Taking human hair as the localization material, one brachial plexus on the left side of the fresh cadaver was serially horizontally sliced with each cryosection 15μin thickness and 0.2mm interval, and than all the slice were stained using Karnovsky－Roots acetylcholinesterase (AChE) histochemical method. To differentiate detailed character,buildup,distribution digital information within every section. And the two -dimensional image of each section was acquired by high-resolution scanner. Then this digital information is put into computer serially. At last précised three-dimensional structure of brachial plexus were reconstructed on computer.Results: 1,The structure of reconstructed brachial plexus is smooth, nature and realistic .It successfully reappearance three-dimensional structure of brachial plexus include its out contour and the ultra-complicated pathways of nerve bundles inside and show the topographic anatomy of every nerve fascicle and its relationship with the nicety localization information of sense fibers and motor ones in arbitrary sections and to present patterns of branching,cross and recombining of nerve bundles in the whole length. We can show the out contour of brachial plexus and the ultra-complicated pathways of nerve bundles inside either separately or together. The result can be rotate or zoomed in any direction and it can be cut in arbitrary position and show the nicety localization information of sense fibers and motor ones.2,The three-dimensional structure of brachial plexus inside is very complicated. The nerve bundles cross and recombine one another. Sense fibers and motor ones in nerve bundles mix together to combine a commix bundle in every part of brachial plexus and it is very hard to separate a single sense bundle or motor one. At last it combines a ultra-complicated nerve network 3,The nerve bundles cross and recombine one another inside of brachial plexus have its special character. Nerve bundles cross and recombine most frequently in the level of trunk. 4,The fascicles number at the level of brachial plexus roots rankis as follow: C7>C6>C8,while as C5 and T1 are the least.5,C7 root appears fascicles with clear dividing line earliest.6,Fascicles number of each part of brachial plexus (...