Ann Arbor, Mich.
From the Department of Surgery, Section of Plastic and Reconstructive Surgery, and the Department of Biomedical Engineering, University of Michigan.
Plast Reconstr Surg. 2018 Mar;141(3):702-710. doi: 10.1097/PRS.0000000000004121.
Peripheral nerve injuries remain a major clinical concern, as they often lead to chronic disability and significant health care expenditures. Despite advancements in microsurgical techniques to enhance nerve repair, biological approaches are needed to augment nerve regeneration and improve functional outcomes after injury.
Presented herein is a review of the current literature on state-of-the-art techniques to enhance functional recovery for patients with nerve injury. Four categories are considered: (1) electroceuticals, (2) nerve guidance conduits, (3) fat grafting, and (4) optogenetics. Significant study results are highlighted, focusing on histologic and functional outcome measures.
This review documents the current state of the literature. Advancements in neuronal stimulation, tissue engineering, and cell-based therapies demonstrate promise with regard to augmenting nerve regeneration and appropriate rehabilitation.
The future of treating peripheral nerve injury will include multimodality use of electroconductive conduits, fat grafting, neuronal stimulation, and optogenetics. Further clinical investigation is needed to confirm the efficacy of these technologies on peripheral nerve recovery in humans, and how best to implement this treatment for a diverse population of nerve-injured patients.
周围神经损伤仍然是一个主要的临床关注点,因为它们常常导致慢性残疾和大量的医疗保健支出。尽管在提高神经修复的显微外科技术方面取得了进展,但仍需要生物学方法来增强神经再生并改善损伤后的功能结果。
本文回顾了目前关于增强神经损伤患者功能恢复的最新技术的文献。考虑了四个类别:(1)电疗,(2)神经引导导管,(3)脂肪移植,和(4)光遗传学。强调了显著的研究结果,重点关注组织学和功能结果测量。
本综述记录了文献的现状。神经元刺激、组织工程和基于细胞的治疗方法的进步在增强神经再生和适当康复方面显示出了希望。
治疗周围神经损伤的未来将包括使用导电导管、脂肪移植、神经元刺激和光遗传学的多模态方法。需要进一步的临床研究来确认这些技术在人类周围神经恢复中的疗效,以及如何最好地为不同人群的神经损伤患者实施这种治疗。