American Society for Peripheral Nerve

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Does Partial Muscle Reinnervation Preserve Future Reinnervation Potential?
Jonathan Isaacs, MD; Satya Mallu, MD; Gaurangkumar Patel, BS; Pooja Shah, BS; Mary Shall, PhD3
Virginia Commonwealth University, Richmond, VA

Introduction: Inadequate recovery following nerve injury or repair offers a difficult treatment dilemma. Partial innervation may have a "baby sitting" or muscle preservation effect. Alternatively, partial reinnervation may only protect a limited percentage of muscle fibers and once a critical time period has passed, revision nerve repair may not improve final motor recovery. Therefore, our purpose was to evaluate final muscle recovery following partial denervation and with and without delayed repair.

Materials & Methods: Sixty (three months old) Sprague-Dawley rats underwent the following tibial nerve manipulations (n=15/group): Group A (partial denervation of tibial nerve - 2/3rds of nerve resected and remaining 1/3rd crushed; revision repair after 8 months with 1cm autograft, and testing at 11 months), Group B (partial denervation and testing at 11 months), Group C (full denervation and immediate reconstruction with 1cm autograft followed by testing at 11 months), Group D (full denervation, delayed reconstruction with 1cm autograft at 8 months, and testing at 11 months). Final testing included functional and morphological assessment.

Results: Muscle weight was significantly (p < 0.01) different between all groups (from highest to lowest: B> C> A> D), with the delayed reconstruction groups (A and D) having the lowest weights. Group A and Group D also had significantly smaller muscle areas than Groups B and C (p < 0.05). Group A and Group D were not significantly different in muscle area when compared to each other. Developed muscle force were not different between groups (p > 0.05).

Conclusions: Partial reinnervation with subsequent delayed reconstruction did not preserve muscle over a long period of denervation compared to partial denervation without repair or full denervation with immediate repair. However, partial reinnervation over a prolonged period in a rat model did result in increased muscle size when compared to delayed repair without partial reinnervation.

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