Peripheral nerve regeneration: The effects of postoperative irradiation

Gregory R.D. Evans, Keith Brandt, K. Kian Ang, Douglas Cromeens, Eric Peden, Giulio Gherardini, Ali Gurlek, Peggy Tinkey, Jeremy Williams

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17 Scopus citations

Abstract

The purpose of this study was to evaluate the effects of postoperative external cobalt-60 beam irradiation on nerve regeneration. Sixty-five 250-gm male Sprague-Dawley rats were studied. Peripheral nerve regeneration was measured by walking track analysis and histomorphology of the proximal, graft, and distal nerve segments. These 65 animals underwent a 1.5-cm interpositional nerve graft into the right posterior tibial nerve. The left leg served as a control. Each animal was then randomly allocated into one of four groups. Group 1 served as control. Groups 2 through 4 were subjected to external cobalt-60 gamma-ray irradiation through a 2.5-cm circular portal for a total fractionated dose of 30, 50, and 70 Gy beginning on post-operative day 3. Radiation was administered in 2-Gy fractions, 5 fractions per week, with a top-up dose of 16 Gy given at the end of the fractionated irradiation. Walking track analysis was performed at 80, 60, 90, and 120 days after nerve grafting. At the conclusion of 120 days, sections of the proximal, grafted, and distal nerve were harvested, stained, and examined histomorphologically. Hematoxylin and eosin stains also were obtained. Evaluation of the print- length index demonstrated no statistical difference between the unirradiated controls and the irradiated groups. The total number of axons per square millimeter and nerve fiber density per square millimeter were significantly decreased in the distal segment of all the irradiated groups when compared with controls. Despite the reduction in myelinated regenerating fibers, no reduction in function was observed, as measured by walking track analysis. We would therefore recommend immediate reconstruction of peripheral nerve defects in the face of postoperative irradiation.

Original languageEnglish
Pages (from-to)375-380
Number of pages6
JournalPlastic and reconstructive surgery
Volume100
Issue number2
DOIs
StatePublished - Aug 1 1997
Externally publishedYes

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    Evans, G. R. D., Brandt, K., Kian Ang, K., Cromeens, D., Peden, E., Gherardini, G., Gurlek, A., Tinkey, P., & Williams, J. (1997). Peripheral nerve regeneration: The effects of postoperative irradiation. Plastic and reconstructive surgery, 100(2), 375-380. https://doi.org/10.1097/00006534-199708000-00015