ElKholy Ahmed Rizk, Sallam Ahmed M, AlShamekh Arwa S, Alomar Najeeb, Alghabban Fatimah A, Alzahrani Basmah S, Bafaqih Saeed M, AlSubaie Fahd A, AlQadasi Khalil S, Alturki Abdulrahman Y, Bafaquh Mohammed
Department of Neurosurgery, Tanta University, Tanta, Egypt.
Department of Neurosurgery, National Neuroscience Institute, King Fahed Medical City, Riyadh, Saudi Arabia.
Surg Neurol Int. 2021 Nov 23;12:568. doi: 10.25259/SNI_586_2021. eCollection 2021.
Different procedures have been developed to improve the surgical outcome of peripheral nerve injuries. The purpose of this study was to evaluate the efficacy of wrapping the neurorrhaphy site utilizing dura substitute graft as an alternative conduit in the management of peripheral nerve injury.
This retrospective clinical case series included 42 patients with a single peripheral nerve injury. The mean age was 26.8 ± 11 years, and the mean duration of symptoms was 3 ± 1.8 months. The visual analogue score (VAS) for pain and the Medical Research Council's (MRC) grading for motor power were used to evaluate the functional outcome among our patients. All patients were operated on for primary microscopic end-to-end repair, followed by wrapping the neurorrhaphy site with dura substitute graft as a conduit. Patients were followed in the outpatient clinic with regular visits for average of 6 months.
Thirty-seven patients (83%), showed functional improvement in all aspects, the VAS for pain and the MRC for motor power, as well as the functional state. One patient (2.3%) developed a postoperative hematoma collection, which needed immediate evacuation. Superficial wound infection, reported in two patients (4.7%), was treated conservatively. No postoperative neuroma was observed among our patients during the follow-up period.
Wrapping the neurorrhaphy site utilizing dura substitute as conduit appears to be safe and might prove effective in managing peripheral nerve injury.
已开发出不同的手术方法来改善周围神经损伤的手术效果。本研究的目的是评估使用硬脑膜替代移植物包裹神经缝合部位作为替代导管在周围神经损伤治疗中的疗效。
本回顾性临床病例系列包括42例单一周围神经损伤患者。平均年龄为26.8±11岁,平均症状持续时间为3±1.8个月。使用疼痛视觉模拟评分(VAS)和医学研究委员会(MRC)的运动力量分级来评估我们患者的功能结局。所有患者均接受了初次显微镜下端端修复手术,随后用硬脑膜替代移植物作为导管包裹神经缝合部位。患者在门诊定期随访,平均随访6个月。
37例患者(83%)在疼痛VAS、运动力量MRC以及功能状态等所有方面均显示功能改善。1例患者(2.3%)出现术后血肿形成,需要立即进行引流。2例患者(4.7%)报告有浅表伤口感染,经保守治疗。在随访期间,我们的患者中未观察到术后神经瘤。
使用硬脑膜替代物作为导管包裹神经缝合部位似乎是安全的,并且可能在周围神经损伤的治疗中被证明是有效的。