Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.
Objective: This study was conducted to confirm the effect of physiotherapy on the balance and walking in dog with sciatic nerve injury and degenerative arthritis of stifle joints. Design: Single case study Methods: The dog walked abnormally for six months and was administrated in S animal hospital. The dog's right hindlimb was operated for cranial cruciate ligament repair and the dog had been taking a nonsteroidal anti-inflammatory analgesic before being refered. There was severe degenerated osteoarthritis in the right hindlimb. During stance and walking, the right hindlimb was often shown partial weight bearing. The dog's left hindlimb was shown plantigrade stance and walking. The radiograph was shown an intact calcaneal tendon in the left hindlimb. In the neurologic examination, sciatic nerve injury in the left hindlimb was confirmed. The dog was treated using muscle strengthening, proprioceptive exercise, underwater treadmill and Laser therapy two, or three times a week for 3 months. At the 10th and 17th treatment, it was evaluated through stance and gait analyzer system to measure dog's balance and walking. Results: 3 months following physiotherapy, the dog's balance was improved in center of pressure(COP). And peak vertical force(PVF), vertical impulse(VI) was increased in right hindlimb and double stance was decreased. Conclusions: Physiotherapy may have improved the prognosis in this dog with severe osteoarthritis and sciatic nerve injury. This study suggested that animal physiotherapy is a valuable way to improve balance and walking.
To confirm the effect of electroacupuncture on the regeneration of injured peripheral nerve, the change of evoked potential in the sciatic nerve, the change of enzyme activity in the spinal cord, and morphological change of injured sciatic nerve were examined comparatively in acupuncture group (AG) and control group (CG) after sciatic nerve of guinea pig was injured by purpose. The value of evoked potential after injury of the sciatic nerve was increased in both AG and CG, but the increase rate of that was higher in AG than CG. Acid phosphatase activity of the spinal cord was increased in 1CG and 2AG, but shown are tendency to return to the normal state as time went by. Ultrastructural recovering rate of the injured sciatic nerve was higher in AG than CG. Also, there was developed only adipose tissue in sciatic nerve of AG. As mentioned above, the effect of electroacupuncture on the regeneration of injured peripheral nerve was confirmed experimentally by change of evoked potential, acid phosphatase and ultrastructure. Especially, the effect of electroacupuncture was appeared clearly in an early stage than other treatment stages.
Objective : This study was carried out to understand effects of ginseng(hearinafter ; GS, Panax Ginseng) extract on regeneration responses on injured sciatic nerves in rats. Methods :Using white mouse, we damaged sciatic nerve & central nerve, and then applied GS to the lesion. Then we observed regeneration of axon and non-neuron. Results : 1. NF-200 protein immunostaining for the visualization of axons showed more distal elongation of sciatic nerve axons in GS-treated group than saline-treated control 3 and 7 days after crush injury. 2. GAP-43 protein was increased in the injured sciatic nerve and further increased by GS treatment. Enhanced GAP-43 protein signals were also observed in DRG prepared from the rats given nerve injury and GS treatment. 3. GS treatment in vivo induced enhanced neurite outgrowth in preconditioned DRG sensory neurons. In vitro treatment of GS on sensory neurons from intact DRG also caused increased neurite outgrowth. 4. Phospho-Erk1/2 protein levels were higher in the injured nerve treated with GS than saline. Phospho-Erk1/2 protein signals were mostly found in the axons in the injured nerve. 5. NGF and Cdc2 protein levels showed slight increases in the injured nerves of GS-treated group compared to saline-treated group. 6. The number of Schwann cell population was significantly increased by GS treatment in the injured sciatic nerve. GS treatment with cultured Schwann cells increased proliferation and Cdc2 protein signals. 7. GS pretreatment into the injured spinal cord generated increased astrocyte proliferation and oligodendrocytes in culture. In vitro treatment of GS resulted in more differentiated pericytoplasmic processes compared with saline treatment. 8. More arborization around the injury cavity and the occurrence at the caudal region of CST axons were observed in GS-treated group than in saline-treated group. Conclusion :GS extract may have the growth-promoting activity on regenerating axons in both peripheral and central nervous systems.
The purpose of this study was to determine effects of the Ga-As (Gallium-Arsenide) Dens-Bio laser on mechanically injured sciatic nerves of rats. The improvement of the injured rat sciatic nerve was evaluated by measuring of nerve conduction velocity and amplitude of compound muscle action potential. The sciatic nerves of forty male Sprague-Dawley rats were compressed with hemostatic forceps for 30 seconds. The experimental group was divided into 4 subgroups according to the duration of treatment. Lower power infrared laser irradiation was done transcutaneously to the injured sciatic nerve area, 3 minutes daily to each of four treatment groups for 1, 3, 5, and 7 weeks, respectively. Compound muscle action potential and nerve conduction velocity of sciatic nerve were obtained before nerve injury and at 1, 3, 5, and 7 weeks after injury. There were significant difference of the nerve conduction velocity and amplitudes of compound muscle action potential between the treatment group and non-treatment group at 1, 3, and 5 weeks after laser treatment. However, there were no differences found between the electrophysiologic parameters that were measured after 7 weeks in two groups. There was significant correlation between the increment of compound muscle action potential and nerve conduction velocity after time course according to laser treatment. In conclusion, the low power laser treatment had improved the sciatic nerve function, and therefore these results may provide the basic data to clarify the neurological recovery and treatment after incomplete peripheral nerve injury.
Jung, Young Jin;Seo, Dong Hyeon;Kim, Han Sung;Ko, Chang-Yong
Journal of Biomedical Engineering Research
/
v.33
no.4
/
pp.207-212
/
2012
It is widely known that sciatic nerve injury (SNI) can negatively affect the biomechanical characteristics of the musculoskeletal system. However, there were no studies that evaluated and compared denervated side with another side limb at the same time. In this study, sixteen male 12-week-old mice were allocated into two groups: HEMI (Right Sciatic nerve denervated) and CON (Control). Both limbs were scanned using micro-CT at 0 week and 4 weeks. There were significant differences in relative variation (RV) of BMD and all structural parameters compared CON and HEMI in right tibia (p < 0.05). Tb.Th and Tb.Sp distributions were differed CON with HEMI in right tibia. In left tibia, there were significant differences in RV of BMD (p < 0.05) and Tb.Sp distribution. These result means that SNI can induce bone loss in the both side tibiae. However, there was a different profile of bone loss between left and right tibiae.
Objectives : This study was aimed to investigate the therapeutic effect of Bogijetongtanggammi-bang (BJTG) on injury of the peripheral nerve tissues. Methods : Rats were divided into 2 groups. The rats of the first group were injected with Taxol (1.25 mg/kg) to their sciatic nerves, once each. The sciatic nerves of the rats of the second group were crushed by forcept for 30 seconds. Rats were administered with BJTG (400 mg/kg) or 0.9% saline for 5 days. Changes of DRG neurons, Schwann cells, Cdc2, caspase 3. phospho-p44/42 Erk1/2, phospho-vimentin and ${\beta}1$ integrin were observed by fluorescent microscope and analysed in western blot. Results : In Taxol-treated SD rat models, BJTG up-regulated neurite outgrowth, Schwann cells, Cdc2 and phospho-Erk1/2, and down-regulated caspase 3. In pressure-injured rat models, BJTG up-regulated axons of sciatic nerve, Schwann cells, Cdc2, phospho-vimentin, ${\beta}1$ integrin, and down-regulated caspase 3. Conclusions : Taken together, BJTG was promotive of nerve regeneration on SNI as well as Taxol-induced nerve injury. BJTG had a pharmaceutical property enhancing recovery of injured peripheral nerves and could be a candidate for drug development after further research.
Objectives : The present study was performed to investigate whether acupuncture stimulation in the rats affected regeneration properties of the injured sciatic nerve. A differential effect of acupuncture stimulation on the one point near the spinal nerve root controlling sciatic nerve activity and the other point in the peripheral area subordinated by injured nerve was compared. Materials and Methods: Rat sciatic nerves were injured by crush, and the effects on axonal regeneration on injured sciatic nerves were evaluated by acupuncture stimulation at two different regions. In proximal acupuncture stimulation group, acupuncture stimulation was performed on Huatuo Jiaji(EX B2) points located from L5 to S1 vertebral levels to stimulate the nearest spinal nerve root that innervates sciatic nerves. In distal acupuncture stimulation group, acupuncture stimulation was performed on Zusanli(ST 36) and Weizhong(BL 40) points to stimulate at peripheral area dominated by injured sciatic nerves. Acupuncture stimulation was given every other days for 1 or 2 weeks. Sciatic nerve tissues collected from acupuncture stimulation experimental groups, injury control group, and intact animal group were used for protein analysis by Western blotting or Hoechst nuclear staining. To determine axonal regeneration, Dil fluorescence dye was injected into the sciatic nerve 0.5 cm distal to the injury site in individual animal groups and Dil-labeled cells by retrograde tracing were measured in the DRG at lumbar 5 or in the spinal cord. DRG sensory neurons prepared from individual animal groups were used to measure the extent of neurite outgrowth and for immunofluorescence staining with anti-GAP-43 antibody. Results : Animal groups given proximal or distal acupuncture stimulation showed upregulation of GAP-43 and Cdc2 protein levels in the sciatic nerve at 7 days after injury. Cdk2 protein levels were strongly induced by nerve injury, but did not show changes by acupuncture stimulation. Phospho-Erk1/2 protein levels were elevated by acupuncture stimulation above those present in the injury control animals. These increase in regeneration-associated protein levels appeared to be related with increase cell proliferation in the injured sciatic nerves. Hoechst 33258 staining of sciatic nerve tissue to visualize nuclei of individual cells showed increased Schwann cell number in the distal portion of the injured nerve 7 and 14 days after injury and further increases by acupuncture stimulation particularly at the proximal position. Measurement of axonal regeneration by retrograde tracing showed significantly increased Dil-labeled cells in proximal acupuncture stimulation group compared to distal acupuncture stimulation group and injury control group. Finally, an evaluation of axonal regeneration by retrograde tracing showed increased number of Dil labeled cells in the DRG at lumbar 5 or in the ventral horn of the spinal cord at lower thoracic level at 7 days after nerve injury. Conclusions : The present data show that the proximal acupuncture stimulation at Huatuo Jiaji(EX B2) points governing injured sciatic nerves was more effective for axonal regeneration than the distal acupuncture stimulation. Further studies on functional recovery or associated molecular mechanisms should be critical for developing animal models and clinical applications.
Objectives : This study was designed to evaluate the effects of Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture on pain reduction and nerve regeneration after crush injury in rat sciatic nerve. Methods : Animal model was produced through crush injury of right sciatic nerve and they were divided into four groups; Group I: no treatment control group; Group II: experimental group treated with Ohyaksungi-san(Wuyaoshungi-san); Group III: experimental group treated with Jungsongouhyul pharmacopuncture; Group IV: experimental group treated with Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture. For the assessment of pain, this study was observed the paw withdrawal latency(PWL) and immunoreactivity on the substance-P. For the assessment of nerve regeneration, the sciatic functional index(SFI) and immunoreactivity on the BDNF were measured. Results : 1. In the assessment of pain, the PWL of experimental groups was significantly higher than control group and group IV was significantly higher than other groups at the all days. 2. In immunohistochemical response of substance-P, as time passes, the immunoreactivity of all groups were decreased gradully. Especially, group IV had the lowest immunoreactivity. 3. In the assessment of SFI, the SFI of experimental groups were significantly higher than control group. 4. In immunohistochemical response of BDNF, the BDNF immunoreactivity of all groups was significantly higher than control group and especially, group IV had the highest immunoreactivity at the 14 days after injury. 5. H & E stain was used on the liver and kidney to investigate toxic effect of Jungsongouhyul pharmacopuncture and Ohyaksungi-san(Wuyaoshungi-san) on on 21 days after injury. However there were no any toxic effects both control group and experimental groups. Conclusions : On the basis of these results, we propose that Ohyaksungi-san(Wuyaoshungi-san) and Jungsongouhyul pharmacopuncture were related to pain reduction and motor nerve recovery, also decreased substance-P expression and increased BDNF expression after crush injury of sciatic nerve, especially these two treatments could be more effective when they were combined simultaneously.
Kim Hui Taek;Yoo Chong Il;Yun Pyung Ju;Lee Jong Seo
Journal of Korean Orthopaedic Sports Medicine
/
v.1
no.1
/
pp.75-78
/
2002
Avulsion of the hamstring tendon from the ischial tuberosity is common in many sports, especially with younger athletes. The injury results from a sudden forceful flexion of the hip joint when the knee is extended and the hamstring muscles powerfully contracted. Early diagnosis and surgical repair with reattachment of avulsed muscles to the ischial tuberosity restore function and correct deformity. But, a delay in the diagnosis and treatment leads to a poor result functionally and clinically. Complication, such as heterotopic ossification and failure of the fixation, etc., were reported following a surgical procedure for this injury. However, sciatic nerve injury has not been reported in the literature. We report our experience of a sciatic nerve palsy after surgery that was performed three months after that the initial injury.
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