Jaimy E Koopman, Lucas G de Groot, Jelle M Zuidam, Liron S Duraku, Carlijn R Hooijmans, Caroline A Hundepool
{"title":"术中短期电刺激能促进周围神经修复后的神经再生吗？系统回顾和荟萃分析。","authors":"Jaimy E Koopman, Lucas G de Groot, Jelle M Zuidam, Liron S Duraku, Carlijn R Hooijmans, Caroline A Hundepool","doi":"10.1016/j.bjps.2025.03.048","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although intraoperative electrical nerve stimulation appears to be a promising neuroenhancing adjunct to peripheral nerve repair, insight into its effects on nerve regeneration is essential to advocate its application in clinical settings.</p><p><strong>Objective: </strong>This study examined whether electrical stimulation during microsurgical repair of peripheral nerve injury results in enhanced nerve regeneration compared to suture repair alone in experimental animals.</p><p><strong>Methods: </strong>A systematic search in Embase, MEDLINE, Web of Science, and Google Scholar databases was performed from inception to March 22, 2024. The search included animal studies assessing outcomes following peripheral nerve repair with and without intraoperative electrical stimulation. Outcomes were subdivided into 4 categories: motor function, sensory function, electrophysiology, and histology. We calculated standardized mean differences and combined these using random effects models to estimate the overall effect. The risk of bias was assessed using the SYRCLE tool.</p><p><strong>Results: </strong>From 3615 references, 21 articles were included. Thirteen studies evaluated motor functional outcomes and showed that electrical stimulation improved functional index, muscle mass, muscle force, footstep accuracy, footprint, and joint angle measures. Six studies examined sensory function and found that electrical stimulation improved mechanical algesimetry. Nine studies assessed electrophysiology outcomes. Although conduction velocity did not differ between the groups, electrical stimulation resulted in a higher amplitude and lower latency. Twenty studies evaluated the histological outcomes and demonstrated increased axon count and myelin thickness, whereas axon diameter and G-ratio did not differ.</p><p><strong>Discussion: </strong>The results suggest that intraoperative electrical stimulation following peripheral nerve repair accelerates and improves nerve regeneration compared with nerve repair alone.</p><p><strong>Systematic review registration: </strong>PROSPERO CRD42023455066.</p>","PeriodicalId":94104,"journal":{"name":"Journal of plastic, reconstructive & aesthetic surgery : JPRAS","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Does short-term intraoperative electrical stimulation enhance nerve regeneration following peripheral nerve repair? 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引用次数: 0
摘要
背景：虽然术中神经电刺激似乎是周围神经修复的一种有前途的神经增强辅助手段，但了解其对神经再生的影响对于提倡其在临床应用至关重要。目的：探讨电刺激在显微外科修复周围神经损伤过程中是否比单纯缝合修复更能促进实验动物神经再生。方法：系统检索Embase、MEDLINE、Web of Science、谷歌Scholar等数据库，检索时间自成立至2024年3月22日。这项研究包括动物研究，评估手术中有无电刺激的周围神经修复的结果。结果分为4类：运动功能、感觉功能、电生理和组织学。我们计算了标准化的平均差异，并使用随机效应模型将这些差异结合起来估计总体效果。使用cycle工具评估偏倚风险。结果：共纳入文献3615篇，21篇。13项研究评估了运动功能结果，并表明电刺激改善了功能指数、肌肉质量、肌肉力量、脚步准确性、足迹和关节角度测量。六项研究检查了感觉功能，发现电刺激改善了机械疼痛测量。9项研究评估了电生理结果。虽然传导速度在两组之间没有差异，但电刺激导致了更高的振幅和更低的潜伏期。20项研究评估了组织学结果，显示轴突计数和髓鞘厚度增加，而轴突直径和g比没有差异。讨论：结果表明，与单纯神经修复相比，术中电刺激周围神经修复后可加速和改善神经再生。系统评价注册：PROSPERO CRD42023455066。
Does short-term intraoperative electrical stimulation enhance nerve regeneration following peripheral nerve repair? A systematic review and meta-analysis.
Background: Although intraoperative electrical nerve stimulation appears to be a promising neuroenhancing adjunct to peripheral nerve repair, insight into its effects on nerve regeneration is essential to advocate its application in clinical settings.
Objective: This study examined whether electrical stimulation during microsurgical repair of peripheral nerve injury results in enhanced nerve regeneration compared to suture repair alone in experimental animals.
Methods: A systematic search in Embase, MEDLINE, Web of Science, and Google Scholar databases was performed from inception to March 22, 2024. The search included animal studies assessing outcomes following peripheral nerve repair with and without intraoperative electrical stimulation. Outcomes were subdivided into 4 categories: motor function, sensory function, electrophysiology, and histology. We calculated standardized mean differences and combined these using random effects models to estimate the overall effect. The risk of bias was assessed using the SYRCLE tool.
Results: From 3615 references, 21 articles were included. Thirteen studies evaluated motor functional outcomes and showed that electrical stimulation improved functional index, muscle mass, muscle force, footstep accuracy, footprint, and joint angle measures. Six studies examined sensory function and found that electrical stimulation improved mechanical algesimetry. Nine studies assessed electrophysiology outcomes. Although conduction velocity did not differ between the groups, electrical stimulation resulted in a higher amplitude and lower latency. Twenty studies evaluated the histological outcomes and demonstrated increased axon count and myelin thickness, whereas axon diameter and G-ratio did not differ.
Discussion: The results suggest that intraoperative electrical stimulation following peripheral nerve repair accelerates and improves nerve regeneration compared with nerve repair alone.
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