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Peripheral Nerve Reconstruction of the Sciatic Nerve in Rats Using Chitosan Hollow Tubes Versus Standard of Care with Nerve Graft
Yuval Shapira; Michael Tolmasov; Nissan Moshe; Reider Evgeni; Shimon Rochkind, MD
Division of Peripheral Nerve Reconstruction, Departments of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
Objective: Traumatic injuries of peripheral nerves represent a major cause for morbidity and disability affecting about 3% of all trauma patients. In cases of peripheral nerve injuries with a nerve defect, autologous nerve grafting is the treatment of choice, however, with extensive nerve loss the clinical outcome of neural repair is often unsatisfactory. The aim of this study was to evaluate, in a preclinical perspective, an innovative biohybrid artificial nerve scaffold for regeneration of injured peripheral nerves.
Methods: In the current study the authors have analyzed 21 rats in two groups comparing nerve reconstruction of the sciatic nerve using chitosan hollow tube versus standard of care with autologous nerve graft. The sciatic nerve was transected in the left hind limb in all rats. In 11 rats chitosan hollow tube was used with a 10mm gap between the proximal and distal ends. In the control group autologous nerve graft was used with end-to-end anastomosis representing the standard of care for nerve reconstruction. Outcome was evaluated during the follow up period using functional sciatic index, electrophysiology, and ultrasonography. After 90 days muscle weight was analyzed along with histology of the proximal and distal parts of the nerves.
Results: Somato-sensory evoked potential and compound muscle action potentials tests along with functional sciatic index demonstrate similar results with no statistically significant difference between the groups. Ultrasonography imaging performed during the follow up period demonstrates nerve tissue proliferation inside the tube. Histology slides of the proximal and distal sciatic nerve 90 days after reconstructive procedure exhibit similar axon numbers and myelin thickness in both groups.
Conclusions: Peripheral nerve reconstruction of the sciatic nerve in rats using chitosan hollow tubes is comparable with autologous nerve grafting while harboring the potential for treatment of larger nerve gaps and functioning as a scaffold with filling material supporting nerve regeneration.
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