• Sara Alicia González Porto, Nieves Domenech, Francisco J Blanco, Alberto Centeno Cortés, Casto Rivadulla Fernández, Ángel Álvarez Jorge, Jacinto Sánchez Ibáñez, and Esther Rendal Vázquez.
• Servicio de Cirugía Plástica, Hospital POVISA, Vigo, Spain.
• Neurosurgery. 2019 Sep 1; 85 (3): 423-431.

BackgroundInsulin-like growth factor 1 (IGF-1) was found to stimulate Schwann cell mitosis. Exogenous IGF-1 may improve nerve regeneration after cryopreservation.ObjectiveTo evaulate the effect of intraneural administration of IGF-1 in cryopreserved nerve isografts.MethodsEighteen millimeter grafts were used for bridging an 18-mm defect in the rat sciatic nerve. A total of 57 rats were randomly divided into three groups: (1) autograft (Group 1); (2) cryopreserved isograft (Group 2); (3) cryopreserved isograft with intraneural IGF-1 administration (Group 3). 12 weeks after surgery, functional recovery (Sciatic functional index [SFI], Swing speed [SS], nerve conduction velocity [NCV], amplitude of compound motor action potentials [CMAP], and gastrocnemius muscle index [GMI]) and nerve regeneration (myelin sheath area, total fiber counts, fiber density, and fiber width) were all evaluated.ResultsThe intraneural injection of IGF-1 significantly improved SFI and SS at weeks 10 and 12. There were no statistical differences between Groups 1 and 3 in any of the SFI or SS evaluations. CMAP and NCV in Group 1 were significantly higher than in Groups 2 and 3, and Group 3 had significantly higher CMAP and NCV compared to Group 2. No significant differences were found in fiber width. The number of nerve fibers, percentage of myelinated fibers, fiber density, and GMI was significantly higher in Group 1 compared to Group 2, but no significant differences were found between Groups 1 and 3.ConclusionThe results show that intraneural injection of IGF-1 in an 18 mm cryopreserved isograft improve axonal regeneration and functional recovery.Copyright © 2018 by the Congress of Neurological Surgeons.

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