An Experimental Study On Treating The Root Avulsion Injury Of Brachial Plexus Via Combining Nerve Root Re-implantation With Motor Nerve Baby-sitting

【Objective】1,To observe the therapeutic effect of nerve root re-implantation in treating brachial plexus avulsion injury. 2,To explore whether motor nerve baby-sitting could improve regeneration of re-implanted nerve root 3,To investigate the differentia of implanted nerve root's regeneration between protophase and persistence motor nerve baby-sitting【Methods】48 Sprague-Dawley rats, weighted from 200g to 250g and unlimited to sex, were provided by the Center for Experimental Animals, Fujian Medical University. They were randomly divided into 3 groups. Simply re-implanted groups(A group):Under operation microscopy, the C5,C6,C7 roots were avulsed and C6 anterior root re-implanted to spine cord after cutting the dorsal root and ganglion pleurale via a posterior approach. Then we cut branches erupt from C6 and affiliate to musculocutaneous nerve via an anterior approach. And the re-implanted C6 anterior root could be connected singly with musculocutaneous nerve. That was the animal model of simply re-implanted groups. Motor nerve persistence baby-sitting group (B group): After complete he animal model of simply re-implanted groups, we sutured the end of medial pectoral nerve to the lateral of musculocutaneous via the anterior approach ; Motor nerve protophase baby-sitting group(C group):we ended medial pectoral nerve baby-sitting one month later. Left side was experimental side and right side was control side. Observe the restoration of elbow flexion, biceps brachii Motion Evoked Potential , biceps brachii wet weight ,muscle fibrin cross section area, musculocutaneous nerve regeneration fibrin, to compare difference of restoration rate in three groups, one ,two and three months later .【Results】1,One month after surgery ,the restoration rate of muscle wet weight, muscle fibrin cross section area and muscle Motion Evoked Potential in Group B increased significantly compared to Group A. 2,Two and three months after surgery, the restoration rate of muscle wet weight and muscle fibrin cross section area in Group B and Group C increased significantly compared to Group A. The restoration rate of muscle wet weight and muscle fibrin cross section area in Group C increased unsignificantly compared to Group B. The restoration rate of muscle Motion Evoked Potential in Group C increased significantly compared to Group B and Group A. The restoration rate of muscle Motion Evoked Potential in Group B decreased significantly compared to Group A, the difference was larger in three months later than that of two months later.【Conclusion】1,In the re-implantation of the nerve root after root avulsion of brachial plexus, the axons can regenerated from neuron to reinnervate muscle. 2,Motor nerve end-lateral baby-sitting can prevent the denervated skeletal muscle from atrophy. 3,Combining protophase motor nerve end-lateral baby-sitting can improve functional restoration of skeletal muscle after nerve root re-implantation in brachial plexus avulsion.