José Damián Carrillo-Ruiz, Armando Armas-Salazar, José Luis Navarro-Olvera, Ana Isabel García-Jerónimo, Fátima Ximena Cid-Rodríguez, José Antonio Rodríguez, Hannia Fernanda González-Morales, Edgar Abarca-Rojano
{"title":"臂丛神经病变手术神经松解术后运动恢复:一个病例研究和系统回顾。","authors":"José Damián Carrillo-Ruiz, Armando Armas-Salazar, José Luis Navarro-Olvera, Ana Isabel García-Jerónimo, Fátima Ximena Cid-Rodríguez, José Antonio Rodríguez, Hannia Fernanda González-Morales, Edgar Abarca-Rojano","doi":"10.1177/09226028241290981","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> The aim of this study is to assess the motor outcomes of patients undergoing surgical neurolysis and to conduct a comprehensive review of existing literature to ascertain the efficacy and utility of this technique. Surgical neurolysis is a procedure designed to liberate an injured nerve from scar tissue or adjacent structure, thereby facilitating nerve regeneration in cases of brachial plexus neuropathy (BPN). <b>Methods:</b> This study presents a case series of patients diagnosed with BPN who underwent surgical neurolysis. The primary focus was on the clinical assessment of recovery using the British Medical Research Council motor grading scale (BMRC). Additionally, a comprehensive literature review was conducted to analyze motor recovery outcomes related to surgical neurolysis for BPN. 18 patients with BPN who underwent surgical neurolysis were included. <b>Results:</b> It was experienced a notable increase of 58% in muscle strength as assessed by the BMRC. The average preoperative state of 2.17 ± 1.15 improved significantly to a postoperative condition of 3.44 ± 1.34 (p = 0.003, d = 0.913) The systematic review identified 2298 relevant articles, out of which 8 articles published between 1995 and 2021 were selected for qualitative analysis, demonstrated that surgical neurolysis was associated with favorable motor recovery outcomes in 75.82% of the patients. <b>Conclusions:</b> Both the case series and the literature review reveal significant motor recovery following surgical neurolysis. It is crucial to conduct well-designed, adequately powered, randomized, and blinded clinical trials. Such studies will provide robust evidence to support or refute the utility of this approach in motor recovery.</p>","PeriodicalId":21130,"journal":{"name":"Restorative neurology and neuroscience","volume":" ","pages":"9226028241290981"},"PeriodicalIF":1.9000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Motor Recovery After Surgical Neurolysis in Brachial Plexus Neuropathy: A Case Study and Systematic Review.\",\"authors\":\"José Damián Carrillo-Ruiz, Armando Armas-Salazar, José Luis Navarro-Olvera, Ana Isabel García-Jerónimo, Fátima Ximena Cid-Rodríguez, José Antonio Rodríguez, Hannia Fernanda González-Morales, Edgar Abarca-Rojano\",\"doi\":\"10.1177/09226028241290981\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> The aim of this study is to assess the motor outcomes of patients undergoing surgical neurolysis and to conduct a comprehensive review of existing literature to ascertain the efficacy and utility of this technique. Surgical neurolysis is a procedure designed to liberate an injured nerve from scar tissue or adjacent structure, thereby facilitating nerve regeneration in cases of brachial plexus neuropathy (BPN). <b>Methods:</b> This study presents a case series of patients diagnosed with BPN who underwent surgical neurolysis. The primary focus was on the clinical assessment of recovery using the British Medical Research Council motor grading scale (BMRC). Additionally, a comprehensive literature review was conducted to analyze motor recovery outcomes related to surgical neurolysis for BPN. 18 patients with BPN who underwent surgical neurolysis were included. <b>Results:</b> It was experienced a notable increase of 58% in muscle strength as assessed by the BMRC. The average preoperative state of 2.17 ± 1.15 improved significantly to a postoperative condition of 3.44 ± 1.34 (p = 0.003, d = 0.913) The systematic review identified 2298 relevant articles, out of which 8 articles published between 1995 and 2021 were selected for qualitative analysis, demonstrated that surgical neurolysis was associated with favorable motor recovery outcomes in 75.82% of the patients. <b>Conclusions:</b> Both the case series and the literature review reveal significant motor recovery following surgical neurolysis. It is crucial to conduct well-designed, adequately powered, randomized, and blinded clinical trials. Such studies will provide robust evidence to support or refute the utility of this approach in motor recovery.</p>\",\"PeriodicalId\":21130,\"journal\":{\"name\":\"Restorative neurology and neuroscience\",\"volume\":\" \",\"pages\":\"9226028241290981\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-02-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Restorative neurology and neuroscience\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/09226028241290981\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NEUROSCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Restorative neurology and neuroscience","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/09226028241290981","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究的目的是评估手术神经松解术患者的运动预后,并对现有文献进行全面回顾,以确定该技术的疗效和实用性。外科神经松解术是一种旨在将受伤神经从瘢痕组织或邻近结构中解放出来的手术,从而促进臂丛神经病变(BPN)的神经再生。方法:本研究报告了一系列诊断为BPN的患者接受手术神经松解术。主要重点是使用英国医学研究委员会运动分级量表(BMRC)对恢复进行临床评估。此外,我们还进行了一项全面的文献综述,分析与BPN手术神经松解术相关的运动恢复结果。18例BPN患者接受手术神经松解术。结果:经BMRC评估,肌肉力量显著增加58%。术前平均状态为2.17±1.15,术后平均状态为3.44±1.34 (p = 0.003, d = 0.913)。系统评价共纳入2298篇相关文献,选取1995 - 2021年间发表的8篇文献进行定性分析,结果显示手术神经松解术与75.82%患者良好的运动恢复结果相关。结论:病例系列和文献综述均显示手术神经松解术后运动恢复显著。进行设计良好、动力充足、随机和盲法的临床试验至关重要。这些研究将提供有力的证据来支持或反驳这种方法在运动恢复中的应用。
Motor Recovery After Surgical Neurolysis in Brachial Plexus Neuropathy: A Case Study and Systematic Review.
Objective: The aim of this study is to assess the motor outcomes of patients undergoing surgical neurolysis and to conduct a comprehensive review of existing literature to ascertain the efficacy and utility of this technique. Surgical neurolysis is a procedure designed to liberate an injured nerve from scar tissue or adjacent structure, thereby facilitating nerve regeneration in cases of brachial plexus neuropathy (BPN). Methods: This study presents a case series of patients diagnosed with BPN who underwent surgical neurolysis. The primary focus was on the clinical assessment of recovery using the British Medical Research Council motor grading scale (BMRC). Additionally, a comprehensive literature review was conducted to analyze motor recovery outcomes related to surgical neurolysis for BPN. 18 patients with BPN who underwent surgical neurolysis were included. Results: It was experienced a notable increase of 58% in muscle strength as assessed by the BMRC. The average preoperative state of 2.17 ± 1.15 improved significantly to a postoperative condition of 3.44 ± 1.34 (p = 0.003, d = 0.913) The systematic review identified 2298 relevant articles, out of which 8 articles published between 1995 and 2021 were selected for qualitative analysis, demonstrated that surgical neurolysis was associated with favorable motor recovery outcomes in 75.82% of the patients. Conclusions: Both the case series and the literature review reveal significant motor recovery following surgical neurolysis. It is crucial to conduct well-designed, adequately powered, randomized, and blinded clinical trials. Such studies will provide robust evidence to support or refute the utility of this approach in motor recovery.
期刊介绍:
This interdisciplinary journal publishes papers relating to the plasticity and response of the nervous system to accidental or experimental injuries and their interventions, transplantation, neurodegenerative disorders and experimental strategies to improve regeneration or functional recovery and rehabilitation. Experimental and clinical research papers adopting fresh conceptual approaches are encouraged. The overriding criteria for publication are novelty, significant experimental or clinical relevance and interest to a multidisciplinary audience. Experiments on un-anesthetized animals should conform with the standards for the use of laboratory animals as established by the Institute of Laboratory Animal Resources, US National Academy of Sciences. Experiments in which paralytic agents are used must be justified. Patient identity should be concealed. All manuscripts are sent out for blind peer review to editorial board members or outside reviewers. Restorative Neurology and Neuroscience is a member of Neuroscience Peer Review Consortium.