• Stanislaw Sobotka, Liancai Mu, Jingming Chen, Jing Li, and Themba Nyirenda.
• Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• Neurosurgery. 2023 May 1; 92 (5): 109110981091-1098.

BackgroundWe have developed a novel reinnervation technique called nerve-muscle-endplate grafting in the native motor zone (NMEG-NMZ). However, it remains unknown whether the NMEG-NMZ is effective for limb reinnervation.ObjectiveTo evaluate the efficacy of the NMEG-NMZ in limb muscle reinnervation.MethodsForty-five adult rats were divided into 3 groups: NMEG, end-to-end anastomosis (EEA, technique control), and denervation control (DC). The left tibialis anterior muscle was denervated by resecting its nerve. For NMEG-NMZ, the denervated tibialis anterior was reinnervated by transferring a NMEG pedicle from the lateral gastrocnemius muscle. Three months after surgery, static toe spread analysis was performed for all rats and muscle force was measured for the rats treated with NMEG and EEA. Muscle weight, myofiber morphology, regenerated axons, and reinnervated motor endplates in the treated muscles were also quantified and compared with those in the DC group.ResultsNMEG-NMZ technique resulted in better muscle force recovery (79% of the control) compared with EEA (51% of the control, P = .048). Toe spread analysis in NMEG-NMZ reinnervated muscles showed static sciatic index = -16.8, whereas -41.4 in EEA, P < .0001). The average weight of the NMEG-NMZ reinnervated muscles (86%) was greater than those of the EEA treated (71%) and DC (26%) muscles (all P < .0001). The mean count of the regenerated axons in the muscles with NMEG-NMZ was 76% of the control, which was larger than that in the muscles with EEA (46%), P < .0001.ConclusionNMEG-NMZ technique has unique advantages and is superior to EEA for muscle reinnervation and functional recovery.Copyright © Congress of Neurological Surgeons 2022. All rights reserved.

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