PRP and other techniques for restoring function across peripheral nerve gaps

IF 3.1 4区 医学 Q2 CLINICAL NEUROLOGY Journal of Neurorestoratology Pub Date : 2024-06-08 DOI:10.1016/j.jnrt.2024.100131
Damien P. Kuffler
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Abstract

Restoring function to peripheral nerves with a gap is challenging, with <50% of patients undergoing nerve repair surgery recovering function. Sensory nerve grafts (autografts) are the clinical “gold standard” for bridging nerve gaps to restore sensory and motor function. They have significant limitations and restore meaningful function only across short gaps when repairs are performed soon after trauma and patients are young. When the value of any of these variables is large, the extent of recovery decreases precipitously, and when two or all are simultaneously large, there is little to no recovery. The extent of restored meaningful recovery has not increased in almost 70 years. Thus, novel techniques are needed that enhance both the extent of recovery and the percentage of patients who recover meaningful recovery. This paper reviews the limitations of autografts and other materials used to repair nerves. It also examines autologous platelet-rich plasma (PRP), a promising nerve gap repair technique that induces recovery in clinical settings where autografts are ineffective, including when the values of all three variables are simultaneously large.

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PRP 和其他恢复周围神经间隙功能的技术
恢复有间隙的周围神经的功能具有挑战性,接受神经修复手术的患者中只有 50%能够恢复功能。感觉神经移植(自体移植)是弥合神经间隙以恢复感觉和运动功能的临床 "金标准"。它们有很大的局限性,只有在创伤后不久进行修复且患者年轻的情况下,才能在短时间内恢复有意义的功能。当其中任何一个变量的值较大时,恢复程度就会急剧下降,而当两个变量或所有变量同时较大时,恢复程度就会很低甚至没有恢复。近 70 年来,有意义的恢复程度一直没有提高。因此,需要新的技术来提高恢复程度和有意义恢复的患者比例。本文回顾了用于修复神经的自体移植物和其他材料的局限性。本文还探讨了自体富血小板血浆 (PRP),这是一种很有前景的神经间隙修复技术,可在自体移植物无效的临床环境中诱导恢复,包括当所有三个变量的值同时很大时。
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来源期刊
Journal of Neurorestoratology
Journal of Neurorestoratology CLINICAL NEUROLOGY-
CiteScore
2.10
自引率
18.20%
发文量
22
审稿时长
12 weeks
期刊最新文献
Authors’ response to correspondence regarding “Application of deep brain stimulation and transcranial magnetic stimulation in stroke neurorestoration: A review” Response to the Letter from Dr. Li et al. for “Two Sides of One Coin: Neurorestoratology and Neurorehabilitation” Letter to Editor: Correspondence to "Two sides of one coin: Neurorestoratology and Neurorehabilitation" Corrigendum to “Comparison of chronic restraint stress-and lipopolysaccharide-induced mouse models of depression: Behavior, c-Fos expression, and microglial and astrocytic activation” [J Neurorestoratol 12 (2024) 100130] Editorial Board
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