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坐骨神经再生的进展:当代技术综述

Advances in sciatic nerve regeneration: A review of contemporary techniques.

作者信息

Ali Sardar, Sun Ming, Khan Muhammad Nadeem, Qiang Fang

机构信息

Department of Biomedical Engineering (BME), Shantou University Shantou 515063, China.

Frontier Research Institute of First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou 515063, China.

出版信息

Regen Ther. 2025 May 6;29:563-574. doi: 10.1016/j.reth.2025.04.016. eCollection 2025 Jun.

Abstract

Sciatic nerve injury, affecting the longest and thickest nerve in the human body, often leads to severe pain, weakness, and impaired motor function in the lower extremities. Despite the peripheral nervous system's inherent capacity for some degree of regeneration, complete recovery remains elusive, necessitating advanced therapeutic approaches. This review explores two promising modalities electrical stimulation (ES) and platelet-rich plasma (PRP) that have shown the potential to enhance nerve repair and functional recovery. ES, through techniques such as transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), and direct current stimulation (DCS), facilitates neuronal regeneration by guiding axonal growth, releasing neurotrophic factors, and promoting synaptic plasticity. PRP, derived from autologous blood, is rich in growth factors such as Platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and nerve growth factor (NGF), which are essential for nerve regeneration, angiogenesis, and reducing inflammation. Clinical evidence supports the efficacy of ES and PRP in promoting nerve regeneration and functional recovery (Figure 1). However, further research is needed to optimize their application and understand their long-term outcomes. This review highlights the potential of these therapies to capitalize on their actions, potentially creating a robust regenerative milieu. Further research is needed to optimize treatment procedures and validate their efficacy and safety in humans.

摘要

坐骨神经损伤会影响人体最长且最粗的神经,常常导致下肢剧痛、无力以及运动功能受损。尽管周围神经系统本身具有一定程度的再生能力,但完全恢复仍然难以实现,这就需要先进的治疗方法。本综述探讨了两种有前景的治疗方式——电刺激(ES)和富含血小板血浆(PRP),它们已显示出增强神经修复和功能恢复的潜力。电刺激通过经皮电神经刺激(TENS)、神经肌肉电刺激(NMES)和直流电刺激(DCS)等技术,通过引导轴突生长、释放神经营养因子和促进突触可塑性来促进神经元再生。富含血小板血浆源自自体血液,富含血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)和神经生长因子(NGF)等生长因子,这些因子对神经再生、血管生成和减轻炎症至关重要。临床证据支持电刺激和富含血小板血浆在促进神经再生和功能恢复方面的疗效(图1)。然而,需要进一步研究以优化它们的应用并了解其长期效果。本综述强调了这些疗法利用其作用的潜力,有可能营造一个强大的再生环境。需要进一步研究以优化治疗程序并验证它们在人体中的疗效和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4438/12138371/af08b2aa4035/gr1.jpg

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