Comparison of the Effects of Extracorporeal Irradiation and Liquid Nitrogen on Nerve Recovery in a Rat Model

Abstract Aim of the study Biologic reconstruction using tumor-bearing bone autografts devitalized by liquid nitrogen or extracorporeal irradiation (oncological sterilization) is a safe and effective method in musculoskeletal surgery. The purpose of this study was to examine the effects of these two oncological sterilization methods on nerve recovery. Methods A total of 48 rats were randomly divided into 3 groups as autograft, irradiation and liquid nitrogen groups. A nerve defect created in the right sciatic nerve was reconstructed with an autograft obtained from the nerve itself. Group I underwent reconstruction with standard nerve autograft. Group II and Group III underwent reconstruction with devitalized nerve autograft treated through extracorporeal irradiation and liquid nitrogen, respectively. The left sciatic nerves of the rats served as control. Electromyography, motor function test and histomorphological analysis were performed to assess the nerve recovery on the 3rd (early stage) and 4th months (late stage). Results Electrophysiological assessment revealed better results in irradiation group compared with liquid nitrogen group in terms of myelinization and axonal regeneration. Motor performance of the autograft group was slightly better than the other groups. Histologically, autograft group demonstrated better results compared with other groups. Late-stage assessments revealed high rates of myelinization in the graft segment in liquid nitrogen group and in the segment distal to the graft in irradiation group. Conclusions This study has demonstrated that nerve autografts treated by oncological sterilization methods may be used for nerve reconstruction in limb salvage surgery. However, further studies are needed to clarify the applicability of these methods.

[1]  W. Robberecht,et al.  In Vivo Electrophysiological Measurement of Compound Muscle Action Potential from the Forelimbs in Mouse Models of Motor Neuron Degeneration , 2018, Journal of visualized experiments : JoVE.

[2]  O. Erbaş,et al.  The Beneficial Effects of Levetiracetam on Polyneuropathy in the Early Stage of Sepsis in Rats: Electrophysiological and Biochemical Evidence , 2013, Journal of investigative surgery : the official journal of the Academy of Surgical Research.

[3]  O. Erbaş,et al.  Comparison of melatonin and oxytocin in the prevention of critical illness polyneuropathy in rats with experimentally induced sepsis. , 2013, The Journal of surgical research.

[4]  A. Shin,et al.  Return of motor function after segmental nerve loss in a rat model: comparison of autogenous nerve graft, collagen conduit, and processed allograft (AxoGen). , 2012, The Journal of bone and joint surgery. American volume.

[5]  Z. Naito,et al.  Comparison of Fixation Methods for Preservation of Morphology, RNAs, and Proteins From Paraffin-Embedded Human Cancer Cell-Implanted Mouse Models , 2011, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[6]  D. K. Cullen,et al.  Biomedical engineering strategies for peripheral nerve repair: surgical applications, state of the art, and future challenges. , 2011, Critical reviews in biomedical engineering.

[7]  L. Li,et al.  Isoflurane preconditioning improves short-term and long-term neurological outcome after focal brain ischemia in adult rats , 2009, Neuroscience.

[8]  Mihye Choi,et al.  Nerve Grafts and Conduits , 2009, Plastic and reconstructive surgery.

[9]  Susan E Mackinnon,et al.  Nerve Allotransplantation as it Pertains to Composite Tissue Transplantation , 2009, Hand.

[10]  Y. Anacak,et al.  Intraoperative extracorporeal irradiation and re-implantation of involved bone for the treatment of musculoskeletal tumors. , 2007, Journal of experimental & clinical cancer research : CR.

[11]  Michael B Chen,et al.  Luminal Fillers in Nerve Conduits for Peripheral Nerve Repair , 2006, Annals of plastic surgery.

[12]  Zhaoqiang Tang,et al.  [An effect of the omental wrapping on revascularization and nerve regeneration of the artificial nerve graft]. , 2006, Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery.

[13]  G. Evans,et al.  Effects of irradiation on nerve graft vasculature. , 2005, Journal of reconstructive microsurgery.

[14]  A. Weir,et al.  Nerve conduction studies: essentials and pitfalls in practice , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[15]  N. Yamamoto,et al.  Reconstruction using an autograft containing tumour treated by liquid nitrogen. , 2005, The Journal of bone and joint surgery. British volume.

[16]  E. Gur,et al.  Free Fibula Long Bone Reconstruction in Orthopedic Oncology: A Surgical Algorithm for Reconstructive Options , 2004, Plastic and reconstructive surgery.

[17]  A Gramsbergen,et al.  Transection of peripheral nerves, bridging strategies and effect evaluation. , 2004, Biomaterials.

[18]  K. Ang,et al.  Peripheral Nerve Regeneration: The Effects of Postoperative Irradiation , 1997, Plastic and reconstructive surgery.

[19]  G. Evans,et al.  Primary nerve grafting: A study of revascularization , 2003, Microsurgery.

[20]  K. An,et al.  Revascularization of nerve grafts: a qualitative and quantitative study of the soft-tissue bed contributions to blood flow in canine nerve grafts. , 2002, The Journal of hand surgery.

[21]  W. Budach,et al.  Reimplantation of extracorporeal irradiated bone segments in musculoskeletal tumor surgery: clinical experience in eight patients and review of the literature , 2002, Langenbeck's Archives of Surgery.

[22]  C B Novak,et al.  Clinical Outcome following Nerve Allograft Transplantation , 2001, Plastic and reconstructive surgery.

[23]  G. Keilhoff,et al.  Cryopreservation of peripheral nerve grafts , 2000, Muscle & nerve.

[24]  G Lundborg,et al.  A 25-year perspective of peripheral nerve surgery: evolving neuroscientific concepts and clinical significance. , 2000, Journal of Hand Surgery-American Volume.

[25]  J. Dunlap,et al.  Slowing of Motor Nerve Conduction Velocity in Streptozotocin-induced Diabetic Rats is Preceded by Impaired Vasodilation in Arterioles that Overlie the Sciatic Nerve , 2000, International journal of experimental diabetes research.

[26]  H. Yoshikawa,et al.  Intraoperative extracorporeal autogenous irradiated bone grafts in tumor surgery. , 1999, Clinical orthopaedics and related research.

[27]  M. Siemionow,et al.  Effect of anti-ICAM-1 antibodies on macromolecular leakage and leukocyte activation: a study of hindlimb allografts in the rat. , 1999, Plastic and reconstructive surgery.

[28]  S. Mackinnon,et al.  Revascularization of peripheral nerve autografts and allografts. , 1999, Plastic and reconstructive surgery.

[29]  Paul L. Evans,et al.  Cold preserved nerve allografts: Changes in basement membrane, viability, immunogenicity, and regeneration , 1998, Muscle & nerve.

[30]  P. Böhm,et al.  Re-implantation of autoclaved bone segments in musculoskeletal tumor surgery , 1998, Archives of Orthopaedic and Trauma Surgery.

[31]  E. Genden,et al.  Long-Segment Nerve Allograft Regeneration in the Sheep Model:Experimental Study and Review of the Literature , 1996, Journal of reconstructive microsurgery.

[32]  Y. Hirasé,et al.  Cryopreserved Allogeneic Vessel and Nerve Grafts: Hind-Limb Replantation Model in the Rat , 1992, Journal of reconstructive microsurgery.

[33]  T. Trumble,et al.  Peripheral Nerve Transplantation: The Effects of Predegenerated Grafts and Immunosuppression , 1992, Journal of neural transplantation & plasticity.

[34]  B Strauch,et al.  A prospective clinical evaluation of autogenous vein grafts used as a nerve conduit for distal sensory nerve defects of 3 cm or less. , 1990, Plastic and reconstructive surgery.

[35]  A L Dellon,et al.  An Alternative to the Classical Nerve Graft for the Management of the Short Nerve Gap , 1988, Plastic and reconstructive surgery.

[36]  H. Roels,et al.  Limb conservation in primary bone tumours by resection, extracorporeal irradiation and re-implantation. , 1988, The Journal of bone and joint surgery. British volume.

[37]  S. Mackinnon,et al.  Peripheral nerve allograft: an immunological assessment of pretreatment methods. , 1984, Neurosurgery.

[38]  M. Stearns.  The effect of irradiation on nerve grafting. , 1982, Clinical otolaryngology and allied sciences.

[39]  C H Tator,et al.  Objective clinical assessment of motor function after experimental spinal cord injury in the rat. , 1977, Journal of neurosurgery.