Summary
The transverse section of the sciatic, tibial and peroneal nerves in rabbits was followed by mobilization in a proximal and distal direction and a tensionfree end-to-end suture of the cut surfaces. The proximal mobilization was performed up to eight different levels between 60 mm and 200 mm, i. e. 20.3% to 67.7% of the total nerve length. Histological findings and their statistical analysis indicated that the critical mobilization length, beyond which ischaemic parenchymal damages occur, is 70 mm or 24% of the total nerve length. Up to this level, the vascular ”extrinsic system“ of the mobilized nerve segments is completely compensated for by the ”intrinsic system“. When the mobilization length is increased, the degeneration distances were more pronounced than those of the ischaemic nerve distances. Some nerves showed no effects from the ischaemia.
Zusammenfassung
An den Nn. ischiadici, tibiales und peronaei von Kaninchen wurden nach transversaler Durchtrennung proximo-distale Mobilisationen vorgenommen und anschließend die freien Stümpfe spannungslos End-zu-End genäht. Die ascendierende Mobilisation erfolgte in 8 verschiedenen Dimensionen zwischen 60 mm und 220 mm, das sind 20,3% bis 67,7% der Nervengesamtlänge. Die kritische Mobilisationslänge eines Nerven, oberhalb welcher ischämische Parenchymschäden auftreten, wurde nach den histologischen Befunden und deren statistischer Auswertung bei 70 mm, entsprechend 24% der Nervengesamtlänge, gefunden. Bis dahin wiesen die mobilisierten Nervensegmente eine vollständige Kompensation der ausgeschalteten äußeren Blutzuflüsse durch das innere Gefäßsystem auf. Mit zunehmender Mobilisationslänge stiegen die Degenerationsstrekken stärker als die ischämischen Nervenstrecken an. Einzelne Nerven blieben ohne Ischämieeffekte.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Adams, W. E.: The blood supply of nerves. II. The effects of exclusion of its regional sources of supply on the sciatic nerve of the rabbit. J. Anat. (Lond.) 77 (1943).
Clauss, G., H. Ebner: Grundlagen der Statistik für Psychologen, Pädagogen und Soziologen. Deutsch, Frankfurt-Zürich 1972.
Denny-Brown, D., C. Brenner: Paralysis of nerve induced by direct pressure and by tourniquet. Arch. Neurol. Psychiat. (Chic.) 51 (1944) 1–26.
Denny-Brown, D., C. Brenner: Lesion in peripheral nerve resulting from compression by spring clip. Arch. Neurol. Psychiat. (Chic.) 52 (1944) 1–19.
Ducker, M. B., L. G. Kempe, G. J. Hayes: The metabolic background for peripheral nerve surgery. J. Neurosurg. 30 (1969) 270–280.
Durward, A.: The blood supply of nerves. Postgrad. med. J. 24 (1948) 11–14.
Glees, P., W. J. H. Nauta: A critical review of studies on axonal and terminal degeneration. Mschr. Psychiat. Neurol. 129 (1955) 74–91.
Hiller, F.: Nerve regeneration in grafts. J. Neuropath. clin. Neurol. 1 (1951) 5–25.
Kline, D. G., E. R. Hackett, G. D. Davis, M. B. Myers: Effect of mobilization on the blood supply and regeneration of injured nerves. J. surg. Res. 12 (1972) 254–266.
Krücke, W.: Erkrankungen der peripheren Nerven. In: Lubarsch, O., F. Henke, R. Rössle: Handbuch der speziellen pathologischen Anatomie und Histologie. Vol. XIII/5, pp. 1–248. Springer, Berlin-Göttingen-Heidelberg 1955.
Krücke, W.: Pathologie der peripheren Nerven. In: Olivecrona, H., W. Tönnis, W. Krenkel: Handbuch der Neurochirurgie. Vol. VII/3, pp. 1–267. Springer, Berlin-Heidelberg-New York 1974.
Lundborg, G.: Ischaemic Nerve Injury. Scand. J. Plast. Reconstr. Surg., Suppl. 6 (1970).
Lundborg, G., P.-I. Brånemark: Microvascular structure and function of peripheral nerves. Vital microscopic studies of the tibial nerve in the rabbit. Adv. Microcirc. 1 (1968) 66–88.
Nobel, W., D. Black: The microcirculation of peripheral nerves: Techniques for perfusion and microangiographic, macrophotographic, and photomicrographic recordings in animals. J. Neurosurg. 41 (1974) 83–91.
Nobel, W., D. Black, P. Johnson, C. Kase: Effect of chronic compression on the microcirculation and function of peripheral nerves. In: Cervós-Navarro, J.: Pathology of cerebral microcirculation. Proc. Int. Symposium, Berlin, Sept. 1973. Walter de Gruyter & Co., Berlin-New York 1974.
Orf, G.: Critical resection length and gap distance in peripheral nerves. Acta neurochir. (Wien), Suppl. 26 (1978).
Orf, G., H. D. Gerhards: Correlation between External Body Dimension and the Length of Peripheral Nerves. Z. Morphol. Anthropol. 71 (1980) 259–267.
Orf, G., H. D. Gerhards: Determining the Length of Peripheral Nerves Indirectly by Regression Analysis. Z. Morphol. Anthropol. 1981 (in press).
Sanders, F. K., J. Z. Young: The degeneration and re-innervation of grafted nerves. J. Anat. (Lond.) 76 (1942) 143–166.
Smith, J. W.: Factors influencing nerve repair. Arch. Surg. 93 (1966) 335–341.
Smith, J. W.: Factors influencing nerve repair. II. Collateral circulation of peripheral nerves. Arch. Surg. 93 (1966) 433–437.
Starkweather, R. J., R. J. Neviaser, J. P. Adams, D. B. Parsons: The effect of devascularisation on the regeneration of lacerated peripheral nerves. An experimental study. J. Hand Surg. 3 (1978) 163–167.
Tarlov, I. M., J. A. Epstein: Nerve grafts: The importance of an adequate blood supply. J. Neurosurg. 2 (1945) 49–71.
Weber, E.: Grundriß der biologischen Statistik. Fischer, Jena 1961.
Weddell, G.: Axonal regeneration in cutaneous nerve plexuses. J. Anat. (Lond.) 77 (1942) 49–62.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Orf, G., Schultheiss, R. A study on the critical mobilization length of peripheral nerves. Neurosurg. Rev. 4, 83–94 (1981). https://doi.org/10.1007/BF01837751
Issue Date:
DOI: https://doi.org/10.1007/BF01837751