• Estefanía Contreras, Sara Traserra, Sara Bolívar, Núria Nieto-Nicolau, Jessica Jaramillo, Joaquim Forés, Eduard Jose-Cunilleras, Xavier Moll, Félix García, Ignacio Delgado-Martínez, Oscar Fariñas, Patrícia López-Chicón, Anna Vilarrodona, Esther Udina, and Xavier Navarro.
• Department of Cell Biology, Physiology and Immunology, Institute of Neuroscience, Universitat Autònoma de Barcelona, Bellaterra , Spain.
• Neurosurgery. 2023 Dec 1; 93 (6): 129613041296-1304.

Background And ObjectivesPeripheral nerve injuries resulting in a nerve defect require surgical repair. The gold standard of autograft (AG) has several limitations, and therefore, new alternatives must be developed. The main objective of this study was to assess nerve regeneration through a long gap nerve injury (50 mm) in the peroneal nerve of sheep with a decellularized nerve allograft (DCA).MethodsA 5-cm long nerve gap was made in the peroneal nerve of sheep and repaired using an AG or using a DCA. Functional tests were performed once a month and electrophysiology and echography evaluations at 6.5 and 9 months postsurgery. Nerve grafts were harvested at 9 months for immunohistochemical and morphological analyses.ResultsThe decellularization protocol completely eliminated the cells while preserving the extracellular matrix of the nerve. No significant differences were observed in functional tests of locomotion and pain response. Reinnervation of the tibialis anterior muscles occurred in all animals, with some delay in the DCA group compared with the AG group. Histology showed a preserved fascicular structure in both AG and DCA; however, the number of axons distal to the nerve graft was higher in AG than in DCA.ConclusionThe decellularized graft assayed supported effective axonal regeneration when used to repair a 5-cm long gap in the sheep. As expected, a delay in functional recovery was observed compared with the AG because of the lack of Schwann cells.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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