ABSTRACT
Increasing doses of therapeutic irradiation are known to impair nerve regeneration
after grafting. One possible factor is the effect of irradiation on the endoneurial
vasculature. This study investigates the effects of postoperative irradiation on the
size, number, and cross-sectional area of endoneurial vessels in the rat posterior
tibial nerve graft model.
Sixty-five Sprague-Dawley rats underwent 1.5-cm interposition grafts to the tibial
nerve. Postoperatively, they were assigned to one of five groups. The animals in Group
1 were unirradiated controls. Groups 2 to 5 received postoperative irradiation in
the amounts of 46, 66, 86, and 106 Gy, respectively. One hundred and twenty days after
grafting, sections of the proximal, grafted, and distal nerve were harvested and analyzed
with digital morphometry. Statistical analysis of the average vessel area, number
of vessels, and total vascular area was performed.
The grafted segments of Groups 4 and 5 and the distal segments of all irradiated groups
showed a statistically significant decrease in the number of vessels, compared to
controls. The average size of the vessel was smaller in the proximal segment of the
irradiated groups, compared to controls. There was no difference in size in either
the grafted or distal segments of the irradiated groups, compared to controls. The
observed changes in the endoneurial vasculature resulted from both the action of regeneration
and the effects of irradiation. The irradiation effects appear to be dose-dependent.
KEYWORDS
Irradiation - peripheral nerve graft - nerve vasculature
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Keith E BrandtM.D.
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine
660 S. Euclid Avenue, Campus Box 8238
St. Louis, MO 63110