Determining the Maximal Length of a Vein Conduit Used as an Interposition Graft for Nerve Regeneration

ABSTRACT

Although autogenous veins have been used as nerve conduits (AVNCs) both experimentally and clinically for short nerve gaps up to 3 cm, investigators have not as yet determined the maximal effective length for functional nerve regeneration. In addition, the role of the distal nerve stump on subsequent nerve growth remains unclear. A rabbit peroneal nerve AVNC model was used to study axonal regeneration through nerve gaps of 1 to 6 cm. After allowing ample time for nerve regeneration, clinical, electophysiologic, and neurohistologic studies were performed to evaluate nerve regrowth and functional muscle reinnervation. Comparisons were made with 6-cm conventional nerve grafts. Excellent growth and function were found with AVNCs up to 3 cm in length, with increasing incapacity for regeneration at lengths greater than 3 cm. The distal nerve stump is believed to play a vital role in nerve regrowth.