Klinická a experimentální studie end-to-side anastomózy periferních nervů a její využití v rekonstrukci pažní pleteně. Vliv neurotrofinů na kvalitu funkční reinervace a na kolaterální reinervaci po end-to-side anastomóze periferních nervů.; Clinical and experimental study of end-to-side neurorrhaphy of peripheral nerves. Significance of end-to-side anastomosis in reconstruction of brachial plexus injury. Evaluation of influence of some neurotrophic factors on collateral reinnervation following end-to-side anastomosis of peripheral nerves in experimental model.

• MeSH
• anastomóza chirurgická MeSH
• granulocyty MeSH
• imunohistochemie využití   MeSH
• neuropatie brachiálního plexu terapie   MeSH
• periferní nervový systém chirurgie   MeSH
• plexus brachialis MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• neurologie
• neurochirurgie
• NLK Publikační typ
• závěrečné zprávy o řešení grantu IGA MZ ČR

OBJECT: The authors present the long-term results of nerve grafting and neurotization procedures in their group of patients with brachial plexus injuries and compare the results of "classic" methods of nerve repair with those of end-to-side neurorrhaphy. METHODS: Between 1994 and 2006, direct repair (nerve grafting), neurotization, and end-to-side neurorrhaphy were performed in 168 patients, 95 of whom were followed up for at least 2 years after surgery. Successful results were achieved in 79% of cases after direct repair and in 56% of cases after end-to-end neurotization. The results of neurotization depended on the type of the donor nerve used. In patients who underwent neurotization of the axillary and the musculocutaneous nerves, the use of intraplexal nerves (motor branches of the brachial plexus) as donors of motor fibers was associated with a significantly higher success rate than the use of extraplexal nerves (81% compared with 49%, respectively, p = 0.003). Because of poor functional results of axillary nerve neurotization using extraplexal nerves (success rate 47.4%), the authors used end-to-side neurorrhaphy in 14 cases of incomplete avulsion. The success rate for end-to-side neurorrhaphy using the axillary nerve as a recipient was 64.3%, similar to that for neurotization using intraplexal nerves (68.4%) and better than that achieved using extraplexal nerves (47.4%, p = 0.19). CONCLUSIONS: End-to-side neurorrhaphy offers an advantage over classic neurotization in not requiring sacrifice of any of the surrounding nerves or the fascicles of the ulnar nerve. Typical synkinesis of muscle contraction innervated by the recipient nerve with contraction of muscles innervated by the donor was observed in patients after end-to-side neurorrhaphy.

• MeSH
• anastomóza chirurgická metody   MeSH
• dospělí MeSH
• financování organizované MeSH
• lidé středního věku MeSH
• lidé MeSH
• míšní nervy transplantace   MeSH
• mladiství MeSH
• následné studie MeSH
• nervový transfer MeSH
• obnova funkce MeSH
• plexus brachialis chirurgie   zranění   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• srovnávací studie MeSH

In view of the Lack of theoretical information, end-to-side neurorrhaphy is a frequent object of experimental interest. End-to-side neurorrhaphy is based on collateral sprouting of an intact axon. The quantitative assessment of collateral sprouts sent by an intact motor and sensory axon was the goal of the present study. End-to-side neurorrhaphy of the distal stump of transected musculocutaneous nerve (MCN) with intact ulnar nerve (UN) was performed in a rat model. Collateral sprouts were quantitatively evaluated by counting of motoneurons and DRG neurons following their retrograde labeling by Fluoro-Ruby and Fluoro-Emerald applied to the UN and MCN, respectively. The results suggest a comparable capacity of both intact sensory and motor axons to send collateral sprouts into a denervated nerve stump. The ratio of sensory/motor neurons, the axons of which reinnervated distal MCN stumps, was very similar to that of intact UN (6.500 and 6.747, respectively), but different from intact MCN (5.029). This suggests that the pruning process occurred to balance the collateral sprouts at a ratio of sensory/motor neurons for the donor UN, but not according to the number of sensory and motor bands of Bungner available in the distal stump of the MCN. The present experimental study confirms end-to-side neurorrhaphy as a suitable method of nerve reconstruction.

• MeSH
• anastomóza chirurgická metody   MeSH
• axonální transport MeSH
• financování organizované MeSH
• krysa rodu rattus MeSH
• mícha cytologie   chirurgie   MeSH
• motorické neurony cytologie   MeSH
• nervus musculocutaneus fyziologie   chirurgie   MeSH
• nervus ulnaris MeSH
• neurony aferentní cytologie   MeSH
• potkani Wistar MeSH
• regresní analýza MeSH
• zvířata MeSH
• Check Tag
• krysa rodu rattus MeSH
• zvířata MeSH

• Publikační typ
• abstrakty MeSH

• MeSH
• dospělí MeSH
• elektrická stimulace MeSH
• elektrokoagulace metody   MeSH
• evokované potenciály účinky záření   MeSH
• financování organizované MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření bolesti MeSH
• míšní kořeny chirurgie   patofyziologie   účinky záření   MeSH
• nezvladatelná bolest chirurgie   patofyziologie   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH