Postgraduate Department, School of Higher Education in Medicine, National Polytechnic Institute, 07340 Mexico City, Mexico.
Functional & Stereotactic Neurosurgery & Radiosurgery Service, General Hospital of México, 06720 Mexico City, Mexico.
J Integr Neurosci. 2023 Jan 17;22(1):25. doi: 10.31083/j.jin2201025.
There are no articles that aim to evaluate the specific role of surgical decompression on the recovery of pain and positive sensory symptoms (PSS) in patients with brachial plexus neuropathy (BPN), as well as the relationship between pain and frequency of sensory manifestations.
A prospective before and after study was performed, considering the pain intensity through the visual analogue scale (VAS), and the frequency of PSS through a proposed new scale: Sensory Frequency of Symptoms Scale (SFSS). To compare the patients before and after the intervention, a paired -test, a Wilcoxon signed-rank test, and Cohen's D test were made, coupled with a Spearman analysis in order to establish the relationship between pain and PSS.
Sixteen patients were included in the study, the clinical evaluation showed changes in pain according with VAS, going from a mean preoperative state of 8.19 to 1.31 after surgery, showing significant changes (84%, < 0.00006, Δ = 2.776). Within the PSS, a significant decrease was observed in paresthesias (74%, < 0.0001, Δ = 1.645), dysesthesias (80%, < 0.002, Δ = 1.453), and allodynia (70%, = 0.031, Δ = 0.635). Conversely, the preoperative correlation analysis between pain and dysesthesias/allodynia showed a low and non-significant relationship (R < 0.4, > 0.05).
Surgical decompression is an effective technique for the relief of pain and sensory manifestations in adult patients with BPN of compressive origin. No relationship was observed between pain and dysesthesias/allodynia. Therefore, during clinical evaluation, they should be considered as independent manifestations, highlighting the need to validate new scales.
目前尚无文章旨在评估手术减压对臂丛神经病（BPN）患者疼痛和阳性感觉症状（PSS）恢复的具体作用，以及疼痛与感觉表现频率之间的关系。
进行了一项前瞻性前后研究，通过视觉模拟量表（VAS）评估疼痛强度，并通过提出的新量表评估 PSS 的频率：感觉症状频率量表（SFSS）。为了比较干预前后的患者，进行了配对检验、Wilcoxon 符号秩检验和 Cohen's D 检验，并进行了 Spearman 分析，以建立疼痛与 PSS 之间的关系。
研究纳入了 16 名患者，临床评估显示 VAS 显示疼痛发生变化，从术前平均 8.19 降至术后 1.31，变化显著（84%，<0.00006，Δ=2.776）。在 PSS 中，感觉异常（74%，<0.0001，Δ=1.645）、感觉迟钝（80%，<0.002，Δ=1.453）和所有痛觉过敏（70%，=0.031，Δ=0.635）均显著下降。相反，术前疼痛与感觉迟钝/所有痛觉过敏之间的相关性分析显示相关性低且无统计学意义（R<0.4，>0.05）。
手术减压是治疗压迫性成人臂丛神经病患者疼痛和感觉表现的有效技术。未观察到疼痛与感觉迟钝/所有痛觉过敏之间存在关系。因此，在临床评估中，应将它们视为独立的表现，突出了验证新量表的必要性。
