Effects of collagen nerve guide on neuroma formation and neuropathic pain in a rat model.
BACKGROUND
Posttraumatic neuroma formation is a major cause of neuropathic pain that can occur after elective surgery, amputation, or trauma. This study examined the use of biosynthetic collagen nerve guides to prevent the development of posttraumatic neuromas.


METHODS
Collagen nerve guides were applied after neurectomy in a rat sciatic nerve model in an effort to stimulate linear neuronal outgrowth and reduce random axon sprouting. Animals were monitored for evidence of neuropathic pain--autotomy scores were recorded for 8 weeks posttransection--after which proximal stumps were excised and processed for histologic analyses.


RESULTS
Moderate to severe autotomy was observed in 88% (7 of 8) of the control (neurectomy) animals. In contrast, 13% (1 of 8) of animals receiving collagen nerve guides developed autotomy, which was significantly less than controls (P < .01). Qualitative analyses of neurofilament and Schwann cell-labeled nerve sections showed a significant enhancement in Schwann cell migration away from the proximal stump and advanced linear axonal regrowth in the collagen nerve guide-treated animals.


CONCLUSIONS
Collagen nerve guides alter the regrowth of transected nerves and reduce the severity of symptoms associated with neuropathic pain.
Tyner
Tim R
TR
Department of Surgery, University Medical Center, University of California San Francisco-Fresno Medical Education Program, 155 N. Fresno St., #308, Fresno, CA 93702, USA. ttyner@fresno.ucsf.edu
Parks
Nancy
N
Faria
Stephanie
S
Simons
Matt
M
Stapp
Brittany
B
Curtis
Brian
B
Sian
Kenty
K
Yamaguchi
Kent T
KT
D000818:Animals; D001672:Biocompatible Materials; D003094:Collagen; D004195:Disease Models, Animal; D008297:Male; D009416:Nerve Regeneration / Q000502:physiology*; D009437:Neuralgia / Q000209:etiology / Q000517:prevention & control; D009463:Neuroma / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation*; D010149:Postoperative Pain / Q000209:etiology; D010524:Peripheral Nervous System Neoplasms / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D016728:Self-Injurious Behavior / Q000209:etiology / Q000517:prevention & control; D023822:Tissue Engineering / Q000379:methods; D020196:Trauma, Nervous System / Q000150:complications
D001672:Biocompatible Materials; D003094:Collagen