Intraoperative Electrical Nerve Stimulation as a Prognostic Tool in Patients Undergoing Peripheral Nerve Neurolysis.

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Tác giả: Unwana Abasi, Christian E Awah, Paul J Cagle, Michael R Hausman, Steven M Koehler, Christoph A Schroen, Yufan Yan

Ngôn ngữ: eng

Ký hiệu phân loại: 620.19304 Engineering mechanics and materials

Thông tin xuất bản: United States : Journal of hand surgery global online , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 675685

PURPOSE: Functional recovery from peripheral nerve injuries remains unpredictable and continues to pose a major clinical challenge to surgeons. This study sought to investigate the utility of intraoperative nerve stimulation following neurolysis surgery as a prognostic indicator of functional recovery. METHODS: A retrospective chart review of adult patients who underwent peripheral nerve neurolysis between September 2021 and December 2022 was performed. A handheld nerve stimulator was used intraoperatively before and after neurolysis. Patients with preoperative motor deficits corresponding to the nerve that underwent neurolysis, intraoperative nerve stimulation, and postoperative follow-up length of at least 3 months were included. Muscle strength as measured by the Medical Research Council scale was used to evaluate nerve function. A scale grade of 0 or 1 meant "no recovery," between 2 and 4 was classified as "partial recovery," and 5 was classified as "full recovery." Fisher exact tests were employed to test for an association between stimulation thresholds and functional recovery. RESULTS: A total of 27 patients and 45 nerves were included in the study, with a mean follow-up of 8.0 months. Intraoperative stimulation at 0.5 mA was observed in 73% (33/45) of nerves, with 76% achieving full recovery, 18% partial recovery, and 6% no recovery. Two nerves stimulated at 2 mA and one at 20 mA, with both showing partial recovery. In contrast, 22% (10/45) of nerves showed no stimulation, leading to full recovery in 20%, partial recovery in 30%, and no recovery in 50% of cases. A significant ( CONCLUSIONS: Intraoperative nerve stimulation is strongly linked to functional recovery postneurolysis, demonstrating its potential as a prognostic tool for guiding surgical decisions. TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic, IV.
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