Successful Reconstruction of Nerve Defects Using Distraction Neurogenesis with a New Experimental Device

introduction: repair of peripheral nerve injuries is an intensive area of challenge and research inmodern reconstructive microsurgery. intensive research is being carried out to develop effectivealternatives to the standard nerve autografting, avoiding its drawbacks. the aim of the study wasto evaluate the effectiveness of a newly designed mechanical device for the reconstruction of thesciatic nerve in rats in comparison to nerve autografting and to assess the pain during the periodof distraction neurogenesis. methods: fourteen sprague dawley rats were used and randomly assigned into 2 groups with7 rats in each group; group a (nerve autografting group) in which a 10-mm segment of thesciatic nerve was resected and rotated 180 degrees, then primary end-to-end neurorrhaphy wasperformed in the reverse direction; group b (nerve lengthening group) in which the mechanicaldevice was inserted after surgical resection of 10 mm of the sciatic nerve, then secondary endto-end neurorrhaphy was performed after completing the nerve lengthening. thirteen weekslater, assessment of the functional sciatic nerve recovery using static sciatic index (ssi) wasperformed. furthermore, fourteen weeks after the nerve resection, assessment of the nerveregeneration with electrophysiological study and histological analysis were performed. also,gastrocnemius wet weight was measured. for pain assessment in group b, rat grimace scale(rgs) score was used. results: significantly better functional recovery rate (using the ssi) was reported in the nervelengthening group in comparison to autografting group. also, a statistically significant highernerve conduction velocity was detected in the nerve lengthening group. on histological analysisof the distal nerve section at 3 mm distal to the nerve repair site, significant myelin sheaththickness was detected in the nerve lengthening group. discussion: distraction neurogenesis with the new experimental device is a reliable therapeuticmethod for the reconstruction of nerve defects.