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首页> 外文期刊>Neurosurgery >Waterjet Dissection of Peripheral Nerves: An Experimental Study of the Sciatic Nerve of Rats
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Waterjet Dissection of Peripheral Nerves: An Experimental Study of the Sciatic Nerve of Rats

机译：水射流解剖周围神经：大鼠坐骨神经的实验研究

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Although waterjet dissection has been well evaluated in intracranial pathologies, little is known of its qualities in peripheral nerve surgery. Theoretically, the precise dissection qualities could support the separation of nerves from adjacent tissues and improve the preservation of nerve integrity in peripheral nerve surgery. OBJECTIVE: To evaluate the potential of the new waterjet dissector in peripheral nerve surgery.METHODS: Waterjet dissection with pressures of 20 to 80 bar was applied on the sciatic nerves of 101 rats. The effect of waterjet dissection on the sciatic nerve was evaluated by clinical tests, neurophysiological examinations, and histopathological studies up to 12 weeks after surgery.RESULTS: With waterjet pressures up to 30 bar, the sciatic nerve was preserved in its integrity in all cases. Functional damaging was observed at pressures of 40 bar and higher. However, all but 1 rat in the 80 bar subgroup showed complete functional regeneration at 12 weeks after surgery. Histopathologically, small water bubbles were observed around the nerves. At 40 bar and higher, the sciatic nerves showed signs of direct nerve injury. However, all these animals showed nerve regeneration after 12 weeks, as demonstrated by histological studies.CONCLUSION: Sciatic nerves were preserved functionally and morphologically at pressures up to 30 bar. Between 40 and 80 bar, reliable functional and morphological nerve regeneration occurred. Waterjet pressures up to 30 bar might be applied safely under clinical conditions. This technique might be well suited to separate intact peripheral nerves from adjacent tumor or scar tissue. Further studies will have to show the clinical relevance of these dissection qualities.
机译：尽管在颅内病理中已经对水刀解剖进行了很好的评估，但是在周围神经外科手术中对水刀的质量了解甚少。从理论上讲，精确的解剖质量可以支持从邻近组织分离神经，并改善周围神经手术中神经完整性的保存。目的：评价新型水刀解剖器在周围神经外科手术中的潜力。方法：对101只大鼠的坐骨神经施以20至80 bar压力的水刀解剖。术后12周通过临床试验，神经生理学检查和组织病理学研究评估水刀解剖对坐骨神经的影响。结果：在水刀压力高达30 bar的情况下，坐骨神经在所有情况下均保持完整。在40 bar和更高的压力下观察到功能损坏。但是，在80 bar亚组中，除1只大鼠外，其余所有大鼠在术后12周均显示出完全的功能再生。组织病理学上，在神经周围观察到小的水泡。在40 bar和更高的压力下，坐骨神经显示出直接神经损伤的迹象。但是，所有这些动物在12周后均表现出神经再生，如组织学研究所证实。结论：坐骨神经在压力高达30 bar的条件下在功能和形态上均得到保留。在40至80 bar之间，发生了可靠的功能和形态神经再生。在临床条件下可以安全地施加高达30 bar的水刀压力。该技术可能非常适合将完整的周围神经与相邻的肿瘤或疤痕组织分离。进一步的研究将不得不显示这些解剖质量的临床意义。

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