Abstract：
Management of peripheral nerve defects is a complicated problem in clinical contexts. Autologous nerve grafting, a gold standard for surgical treatment, has been well known to have several limitations, such as donor site morbidity, a limited amount of available donor tissue, and size mismatches. Acellular nerve allografts (ANAs) have been developed as an alternative and have been applied clinically with favorable outcomes. However, because of the limited availability of commercialized ANAs due to supplier-related issues and high costs, efforts continue to produce alternative sources for ANAs. The present study evaluated the anatomical and histological characteristics of human peripheral nerves using 25 donated human cadavers. The length, diameter, and branching points of various peripheral nerves (median, ulnar, tibial, lateral femoral cutaneous, saphenous, and sural nerves) in both the upper and lower extremities were evaluated. The cross-sectional area (CSA), ratio of fascicular area, and numbers of fascicles were also evaluated via histologic analysis. CSA, the ratio of fascicular area, and the number of fascicles were analyzed statistically in correlation with demographic data (age, sex, height, weight, BMI). The mean length of all evaluated nerves ranged from 17.1 to 41.4 cm, and the mean diameter of all evaluated nerves ranged from 1.2 to 4.9 mm. Multiple regression analysis revealed correlations between the ratio of fascicular area and sex (p = 0.005) and BMI (p = 0.024) (R2 = 0.051). The results of the present study will be helpful in selecting necessary nerve allograft sources while considering the characteristics of each nerve in the upper and lower extremities during ANAs production.
摘要：
周围神经缺损的治疗在临床上是一个复杂的问题。自体神经移植,手术治疗的黄金标准,众所周知，有几个限制，例如供体部位的发病率，有限的可用供体组织，和大小不匹配。脱细胞神经同种异体移植物（ANA）已被开发为替代方案，并已在临床上应用，取得了良好的效果。然而,由于与供应商相关的问题和高成本，商业化的ANA的可用性有限，努力继续为ANA生产替代来源。本研究使用25例捐赠的人类尸体评估了人类周围神经的解剖和组织学特征。长度,直径,和各种周围神经的分支点(正中，尺骨,胫骨,股外侧皮肤，大隐,和腓肠神经）在上肢和下肢都进行了评估。横截面积（CSA），束状面积比，并通过组织学分析评估了分束数。CSA,束状面积的比率，并将分束数与人口统计学数据(年龄，性别,高度,体重,BMI）。所有评估神经的平均长度范围为17.1至41.4厘米，所有评估神经的平均直径为1.2至4.9mm。多元回归分析显示，束区面积与性别的比值（p=0.005）与BMI（p=0.024）（R2=0.051）之间存在相关性。本研究的结果将有助于选择必要的同种异体神经移植物来源，同时考虑ANA生产过程中上肢和下肢每条神经的特征。
