The Research About The1,2Transposition To Reconstruct The Sacral Nerves Root Avulsion

Nowadays, people travel faster than before. So, severe trafficinjuries increase. Pelvic fracture becomes common in the clinical work.Ventral root avulsion or ventral injury arisen from pelvic fracture comessubsequently. We have no efficient methods to deal with them. For a longperiod, conservative treatment was the first choice for this kind ofinjuries. In recent years, some doctors tried surgeries. The most adoptedmethod was ventral nerves exploration. Patients could hardly getsatisfied outcome. CHEN Aimin et al. used the contralateral L1root asa power source nerve to repair sacral root avulsion, and they had primarilyconfirmed its security and validity. Then a new problem occurred, we needmore power source nerves for the repair. Lumbar plexus may be a idealchoice. After operation, We used to evaluate many aspects of theeffectiveness of this method of treatment. Part oneObjective: to evaluate the security of cutting L2as a power sourcenerve and find out the degeneration law of the target cell.Method: sixty adult SD rats were chosen at random to establish thesacral nerve root models by avulsing the right side of L4-L6rat nerveroots of the intervertebral foramen without laminectomy. These rats weredivided into three groups at random, group1was control group (sham group),L2nerve roots of rats in group2were cut off outside the intervertebralforamina, and L2and L6nerve roots of rats in group3were cut off outof the intervertebral foramina. These models are the rat, BBB ratedsurvival assessments, the double biceps femoris, tibialis anterior andtriceps muscle fiber CSA (cross-sectional area).Results:1.three months after operation, the survival rates of threegroups were95%,90%,90%respectively.2.The mean BBB scores were17.78±2.24,17.45±3.15,16.98±4.26.3.No limb ulcer was found in group1and group2, a rat in group3had slight plantar ulcer.Conclusion: we confirmed the security of cutting off L2as a powersource nerve. Part twoObjective: To evaluate the efficiency of the L2transposition toreconstruct the sacral plexus avulsion injury.Methods: ninety adult rats with sacral plexus avulsion were dividedinto three groups at random. Group1was control group (sham group), ratsin group2were adopted L2transposition for the reconstruction theinjured contralateral sacral plexus, and rats in group3were adopted L6to reconstruct the injured contralateral sacral plexus. After surgery,the rats in each group were selected for nerve tissue morphology underthe electron microscope and microscope. The rats were evaluated with eachgroup, electron microscopy weight, BBB rating and muscle fiber CSA(cross-sectional area) of the double-biceps femoris, tibialis anteriorand triceps survival.Results: three months after operation, the BBB scores indicatedsignificant differences between2experimental groups and the controlgroups. We found that in the double biceps femoris muscle weight and fiberCSA, tibia significant difference in the proportion of muscle and tricepssurae between2experimental groups and the control group. In the group2and group3, the biceps femoris, tibialis anterior and triceps recoveryis different. The former was better than the latter. Observation of nervetissue was under the microscope and microscopic morphology electronic.Conclusion: the L2transposition with autograft of nerve roots canreconstruct partial function of sciatic nerve the in paraplegia rats. L2was also a effective choice when more power source nerves were needed. Part threeObjective: to evaluate the degeneration of the target muscle aftersacral plexus avulsing injury.Methods:60adult SD rats with sacral plexus avulsion were chosenat random. Rats were divided into6groups at random. Group1-6. Both sidesof biceps femoris, triceps surae and tibial muscle were drawn from a groupat2w,4w,6w,8w,10w, and12w after operation. Muscle wet weights, musclefiber cross section areas and myocyte diameters were measured. Thehistomorphology of the motor endplate was also observed.Results: muscle wet weights, muscle fiber cross section areas andmyocyte diameters of the denervated muscle decreased progressively.Within4weeks, the motor endplate showed no significant change, they beganto disappear after4weeks, and after12weeks, they were hardly found.Conclusion: muscle wet weights, muscle fiber cross section areas andmyocyte diameters of the denervated muscle decreased progressively. Themotor endplate began to disappear after4weeks. Part fourObjective: to evaluate the law of central reconstruction of rat withL2transposition to reconstruct the sacral plexus avulsing injury.Method:30adult SD rats were divided into three groups at random.Rats in group1were with right sacral plexus avulsion injury, in group2were adopted with L2transposition, and in group3were normal (shamgroup). Sixteen weeks after operation, without feeding for12hours,0.2ml18F-FDG was injected into rat from tail vein. Electrical stimulation wasgiven on right lower limbs. Rats would undergo pet-CT scan40minutes later,total brain and neck were contained.Results: rats in group1showed no significant imaging in bothcerebral hemispheres, in group2showed significant imaging in bothcerebral hemispheres, and in group3showed significant imaging in leftcerebral hemisphere.Conclusion: reconstruction of cerebral cortex is the symbol ofsuccessful nerve transposition.