title: Repairing the ventral root is sufficient for simultaneous motor and sensory recovery in multiple complete cervical root transection injuries.
abstract: OBJECTIVE
  In multiple cervical root transection injuries, motor and sensory recovery has been demonstrated after repairing both dorsal and ventral roots with autologous grafts applied to the dorsal and ventral aspects, respectively. However, in clinical situations, autologous grafts may not be sufficient to repair both roots in this situation. In this study, the authors evaluated whether repairing ventral root alone is sufficient for simultaneous sensory and motor function recovery.
  
  
  METHODS
  In the transected group, the left 6th-8th cervical roots were pulled and transected at the spinal cord junction. In the repair group, the transected root was anastomosed to a single autologous nerve graft, which was inserted into the ventral horn through a pial incision. Acidic fibroblast growth factor mixed with fibrin glue was applied to the surgical area. Motor function, sensory function, cortical somatosensory evoked potentials (SSEPs), axon tracing, and CGRP(+) fibers were evaluated.
  
  
  RESULTS
  The repaired rats exhibited simultaneous sensory and motor function recovery. At the 16th weeks, SSEPs reappeared in all animals of the repair group, but not in the transected group. Retrograde axon tracing demonstrated an increased number of sensory neurons in the dorsal root ganglia and regenerating nerve fibers in the dorsal horn. CGRP(+) fibers were significantly increased in the repair group and restricted to laminae I and II.
  
  
  CONCLUSIONS
  This is the first report that in multiple root avulsions with insufficient grafts, repairing ventral roots alone leads to both sensory recovery and motor recovery. This finding may help patients with multiple cervical root avulsions.
authors.affiliation: Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yi-Lo
authors.initials: YL
authors.lastname: Lin
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Kai-Ting
authors.initials: KT
authors.lastname: Chang
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Chi-Te
authors.initials: CT
authors.lastname: Lin
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: May-Jywan
authors.initials: MJ
authors.lastname: Tsai
authors.affiliation: Division of Neural Regeneration and Repair, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yun-An
authors.initials: YA
authors.lastname: Tsai
authors.affiliation: Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yi-Yen
authors.initials: YY
authors.lastname: Lee
authors.affiliation: Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Shu-Chin
authors.initials: SC
authors.lastname: Chien
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Neural Regeneration and Repair, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Wen-Cheng
authors.initials: WC
authors.lastname: Huang
authors.affiliation: Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yang-Hsin
authors.initials: YH
authors.lastname: Shih
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Department and Institute of Pharmacology, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Neural Regeneration and Repair, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Henrich
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Neural Regeneration Laboratory, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: mchuang@vghtpe.gov.tw.
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Huang
mesh_terms: D000818:Animals; D001369:Axons / Q000473:pathology / Q000502:physiology; D019054:Evoked Potentials, Motor; D005073:Evoked Potentials, Somatosensory; D005260:Female; D009416:Nerve Regeneration; D051381:Rats; D017207:Rats, Sprague-Dawley; D013126:Spinal Nerve Roots / Q000293:injuries* / Q000473:pathology / Q000502:physiology*; D013127:Spinal Nerves / Q000637:transplantation*
keywords: Nerve root transection; Somatosensory evoked potentials; Ventral root repair