Axonal supercharging technique using reverse end-to-side neurorrhaphy in peripheral nerve repair: an experimental study in the rat model

Object In an attempt to improve peripheral nerve repair, the influence of the addition of reverse end-to-side neu-rorrhaphy for an injured peripheral nerve was investigated in the rat sciatic nerve transection model. Methods Twelve Sprague–Dawley rats were divided into two groups (six rats in each group). In Group I, the right sciatic nerve was cut at a point distal to the gluteal notch and repaired using end-to-end neurorrhaphy with four 10-0 nylon epineurial sutures. In Group II, after performing the same procedure as in Group I, the left sciatic nerve was cut distally and passed through a subcutaneous tunnel to the right side. The proximal stump of the left sciatic nerve was coapted to the epineurial window of the right sciatic nerve distal to the injured point in an end-to-side fashion using 10-0 nylon epineurial sutures. The effects were evaluated using analgesimeter recordings for the hind paw, electrophysiological tests, measurement of the muscle contraction force, a double-labeling technique, weight measurement and histological examination of the gastrocnemius muscle, histological examination of the bilateral sciatic nerves, and immunofluorescent staining. Results Results from the many tests used to evaluate the reverse end-to-side neurorrhaphy technique indicated thatfunctional recovery of the denervated target organs was promoted by axonal augmentation. Conclusions The reverse end-to-side neurorrhaphy technique could be useful in peripheral nerve repair.