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Calcium Absorption Osmotic Pump Improves Nerve Regeneration After Transection Injury and Repair
John Davis, BS, Ji-Geng Yan, MD, Hani Matloub, MD and Michael Agresti, MS
Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI
Purpose: To validate the effect of Ca2+ - absorption osmotic pumps in nerve transection injury and repair. Materials and Methods: 16 SD adult male rats divided into two groups of 8 for each. Sham Control Group: Sciatic nerve was transected at the mid-point, and then it was directly repaired by end-to-end coaptation using 10-0 nylon with 4 sutures without using pump (because that in C1.4 study, the results of Saline-pump vs. no-pump showed no different). Calcitonin Pump Group: Sciatic nerve was transected and repaired by the above way. A Calcitonin micro-osmotic pump with an attached catheter was used which was placed parallel to the repaired nerve. Calcitonin was used at a concentration of 1.25ug/ml, and rat received 4.5ng per day Evaluation: The rats were then allowed to recover for 12 weeks. The evaluations included: 1) An EMG test which was Compound Muscle Action Potential (CMAP) recording on the extensor digital longus muscle (EDL) muscle; 2) Tetanic muscle force test (TMF) of EDL muscle; 3) Nerve calcium concentration (NCC) as measured by Calcium Green-1AM stain; and 4) Other histological studies on the distal sciatic nerve segment to the transected site, including nerve fiber count (NFC) and calcified spots (CS) count using toluidine blue-stained cross sections. To eliminate animal bias, the average recovery rate comparison was used (The average recovery rate = the average value on the experimental right side divided by the average value on the normal left side). Results: Calcitonin pump group showed vastly superior recovery compared to the sham control group among the functional and histological recovery parameters examined: CMAP (%) 83.6±5.4 vs 66.9±8.8, TMF(%) 82.3±4.6 vs 56±4.4, NCC (10-3 M) 2.30±0.15 vs 2.89±0.32, NFC (#) 4011±428 vs 3264±305, and CS (#) 31±17 vs 122±51. Conclusion: We conclude from this study that nerve regeneration strongly correlated with calcium absorption; the data presented with the calcitonin micro-osmitic pump has shown greatly improved nerve functional recovery, which can potentially be translated into clinical implications.
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