Couch Brandon, Hayward Dan, Baum Gracie, Sakthiyendran Naveen Arunachalam, Harder Justin, Hernandez Evan J, MacKay Brendan
Texas Tech University Health Sciences Center, Lubbock, TX, United States.
Department of Orthopaedic Hand Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States.
Front Neurol. 2024 Sep 2;15:1434429. doi: 10.3389/fneur.2024.1434429. eCollection 2024.
The use of corticosteroids has become a part of the standard of care in various pathologies but their use in peripheral nerve injury treatment is limited. Given corticosteroids' anti-inflammatory properties and their regulatory role in neuronal protein production and myelination, corticosteroids could serve as an adjunct therapy for peripheral nerve injuries. This review aims to systematically investigate the current use of corticosteroid treatment in peripheral nerve pathologies.
The systematic search was performed on PubMed, MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science using keywords such as "corticosteroid treatment," "peripheral nerve damage," "peripheral neuropathy," and "complications." The PRISMA guidelines were used to conduct the systematic review and all articles were reviewed by the corresponding author. After the initial search, individual study titles and abstracts were further screened and categorized using an inclusion and exclusion criteria followed by a final full-text review.
Out of the total 27,922 identified records, 203 studies were included based on the selection criteria. These studies focused on the use and efficacy of steroids across a spectrum of compression and non-compression peripheral neuropathies such as cubital tunnel syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. Various studies noted the promising role of steroids in offering pain relief, nerve block, and nerve regeneration effects. Additionally, safety considerations and potential complications regarding steroid use in peripheral nerve injuries were analyzed.
While there is currently limited clinical utilization of corticosteroids in peripheral nerve pathologies, the anti-inflammatory and regenerative effects that steroids provide may be a beneficial tool in managing various peripheral neuropathies and their associated pain. Additional clinical trials and investigation into the mechanism of action could improve the reputation of steroid use as peripheral nerve injury treatment.
皮质类固醇的使用已成为各种病症标准治疗的一部分,但它们在周围神经损伤治疗中的应用有限。鉴于皮质类固醇的抗炎特性及其在神经元蛋白质产生和髓鞘形成中的调节作用,皮质类固醇可作为周围神经损伤的辅助治疗方法。本综述旨在系统研究皮质类固醇治疗在周围神经病症中的当前应用情况。
在PubMed、MEDLINE、EMBASE、Scopus、Cochrane和Web of Science上进行系统检索,使用“皮质类固醇治疗”、“周围神经损伤”、“周围神经病变”和“并发症”等关键词。采用PRISMA指南进行系统综述,所有文章均由通讯作者审阅。在初步检索后,根据纳入和排除标准对各个研究的标题和摘要进行进一步筛选和分类,随后进行最终的全文审查。
在总共识别出的27922条记录中,根据选择标准纳入了203项研究。这些研究聚焦于类固醇在一系列压迫性和非压迫性周围神经病变(如肘管综合征和慢性炎症性脱髓鞘性多发性神经根神经病)中的使用和疗效。各种研究指出类固醇在缓解疼痛、神经阻滞和神经再生方面具有潜在作用。此外,还分析了类固醇用于周围神经损伤时的安全性考量和潜在并发症。
虽然目前皮质类固醇在周围神经病症中的临床应用有限,但类固醇所提供的抗炎和再生作用可能是管理各种周围神经病变及其相关疼痛的有益手段。进一步的临床试验和对作用机制的研究可能会改善类固醇作为周围神经损伤治疗方法的声誉。