Prince of Wales Clinical School, University of New South Wales, Randwick, New South Wales, Australia Brain and Mind Research Institute, The University of Sydney, Camperdown, New South Wales, Australia.
Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
J Neurol Neurosurg Psychiatry. 2016 Feb;87(2):198-208. doi: 10.1136/jnnp-2014-310175. Epub 2015 Apr 28.
Peripheral nerve trauma frequently affects younger people and may result in significant and long-lasting functional disability. Currently, diagnosis and monitoring of peripheral nerve injury relies on clinical and electrodiagnostic information, supplemented by intraoperative electrophysiological studies. However, in a significant proportion of nerve injuries, the likelihood of spontaneous regeneration resulting in good functional outcome remains uncertain and unnecessary delays to treatment may be faced while monitoring for recovery. Advances in non-invasive imaging techniques to diagnose and monitor nerve injury and regeneration are being developed, and have the potential to streamline the decision-making process. In addition, advances in operative and non-operative treatment strategies may provide more effective ways to maximise functional outcomes following severe peripheral nerve trauma. This review discusses these advances in light of the current state of the art of management of peripheral nerve trauma.
周围神经创伤常发生于年轻人,可能导致严重且持久的功能障碍。目前,周围神经损伤的诊断和监测依赖于临床和电诊断信息,并辅以术中电生理研究。然而,在很大一部分神经损伤中,自发再生导致良好功能结果的可能性仍然不确定,在等待恢复的过程中可能会面临不必要的治疗延误。用于诊断和监测神经损伤和再生的无创成像技术正在不断发展,并且有可能简化决策过程。此外,手术和非手术治疗策略的进步可能为严重周围神经创伤后的功能恢复提供更有效的方法。本文根据周围神经创伤管理的最新技术进展,对这些进展进行了讨论。