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L4-to-L4 nerve root transfer for hindlimb hemiplegia after hypertensive intracerebral hemorrhage

Neural Regeneration Research 2022年第6期17卷 1278-1285页

作者： Teng-Da Qian Xi-Feng Zheng Jing Shi Tao Ma Wei-Yan You Jia-Huan Wu Bao-Sheng Huang Yi Tao Xi Wang Ze-Wu Song Li-Xin Li Department of Neurosurgery Jintan HospitalAffiliated Hospital of Jiangsu Vocational College of MedicineJintanJiangsu ProvinceChina Department of Gastroenterology Jintan HospitalAffiliated Hospital of Jiangsu Vocational College of MedicineJintanJiangsu ProvinceChina Department of Neurosurgery Changzhou First People’s HospitalSuzhou UniversityChangzhouJiangsu ProvinceChina Deparment of Neurobiology Basic Medical CollegeNanjing Medical UniversityNanjingJiangsu ProvinceChina Department of Neurosurgery Sir Run Run Hospital Affiliated to Nanjing Medical UniversityNanjingJiangsu ProvinceChina Department of Neurosurgery Affiliated Cancer Hospital of Nanjing Medical UniversityNanjingJiangsu ProvinceChina Department of Neurosurgery First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu ProvinceChina

There is no effective treatment for hemiplegia after hypertensive intracerebral *** that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve *** models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal *** L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the *** investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral *** a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over *** 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic *** 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve *** addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal *** and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination *** findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal *** from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrh

关键词： central hemiplegia end-to-end anastomosis functional regeneration hypertensive intracerebral hemorrhage L4 nerve root neural regeneration neurotization rat model reinnervation skilled restoration

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