Nerve Compression Research Articles

Lower extremity nerve decompression for superimposed peripheral neuropathy in diabetes: awareness among medical professionals.

In 2009, a Dutch survey disclosed that 23% of medical professionals involved in diabetes care acknowledged the role of superimposed nerve compression in diabetic sensorimotor polyneuropathy (DSP) symptoms, although less than 10% were aware of the potential value of nerve decompression surgery. Our current aim was to assess whether awareness changed since this survey together with an updated review of the literature. A cross-sectional, national, multi-institutional survey-based study was conducted among professionals from different specialties in the Netherlands including general practitioners, endocrinologists, neurologists, plastic surgeons, vascular surgeons, orthopedic surgeons, neurosurgeons, anesthesiologists, diabetes specialist nurses and podiatrists. Among the 730 respondents, 84% confirmed their involvement in diabetes care. 57% (versus 23% in 2009) stated to be aware of the concept that superimposed nerve compressions play a role in the symptoms of DSP and 74% (previously: 60%) believed that this could be the case. In their communication to patients, 78% (versus 45%) of the professionals explained that DSP was irreversible. 30% (versus 3%) reported to refer patients to a surgeon. The reviewed literature reports an encouraging effect regarding pain reduction and PROMs, albeit with inconsistencies in outcomes related to sensibility (static one-point, two-point discrimination) and nerve conduction parameters. In the last 13 years, studies reporting positive effects of surgery on both patient-reported outcomes and post-operative pain have raised an increased awareness on lower extremity neuropathy and LEND surgery with significantly more referrals to surgeons. However, long-term outcomes and appropriate patient selection criteria for LEND surgery are still needed.

Comparison of the efficacy of peloid therapy and paraffin treatment in carpal tunnel syndrome.

Carpal tunnel syndrome (CTS) is a common neuropathy caused by median nerve compression at the wrist, managed with treatments like splinting, physical therapy, injections, and surgery. This study aimed to compare the effectiveness of paraffin and peloid therapies combined with night splint use in reducing symptom severity, improving functional status, and enhancing electrophysiological findings in patients with mild to moderate CTS.Sixty patients with mild to moderate CTS scheduled for paraffin or peloid therapy with night splint use were included. Symptom severity was assessed using the Visual Analog Scale (VAS) and the Boston Carpal Tunnel Syndrome Questionnaire's Symptom Severity Scale (BSSS). Functional status was evaluated with the Functional Status Scale (BFSS). Electrophysiological parameters, including distal sensory latency (DSL), distal motor latency (DML), sensory nerve action potential (SNAP), compound muscle action potential (CMAP), sensory conduction velocity (SCV), and motor conduction velocity (MCV), were measured via electromyography (EMG). Assessments were performed at baseline, and at the 4th and 12th weeks post-treatment. Both therapies significantly improved VAS and BSSS scores at the 4th and 12th weeks (p < 0.05). Functional status improved only in the paraffin group (p < 0.05). Electrophysiological improvements in DSL and DML were significant in the paraffin group (p < 0.05), while no significant changes were noted in the peloid group. Between-group comparisons showed significant differences in DSL, DML, and SCV in favor of paraffin (p < 0.05). Paraffin and peloid therapies with night splint use reduce CTS symptom severity, but paraffin is superior in improving function and nerve conduction.

Comparing the Carpal Tunnel Area and Carpal Boundaries in Patients with Carpal Tunnel Syndrome and Healthy Volunteers: A Magnetic Resonance Imaging Study

Background: Carpal tunnel syndrome (CTS) is a common neuropathy caused by compression of the median nerve (MN) within the carpal tunnel, which causes pain, paresthesia, or altered sensation. While a small carpal tunnel area is considered a risk factor for CTS, varying carpal tunnel dimensions in CTS patients have been obtained via axial computed tomography and magnetic resonance imaging (MRI). Methods: In this retrospective study, MR images from 49 CTS patients and 38 healthy controls were analyzed to investigate differences in the carpal tunnel area and carpal boundaries between the groups and to explore the relationships of these parameters with CTS severity. Results: Our findings revealed that compared with the controls, CTS patients presented significantly larger cross-sectional areas (CSAs) of the MN and carpal tunnel and increased MN flattening ratios. The CSAs of the MN showed moderate positive correlations with severity (r = 0.395, p &lt; 0.001), symptom score (r = 0.354, p &lt; 0.001), and disability score (r = 0.300, p &lt; 0.001), while the carpal tunnel area showed weaker but significant correlations with severity (r = 0.268, p = 0.002), symptom score (r = 0.173, p = 0.026), and disability score (r = 0.183, p = 0.018). The ratios of the MN CSA to those of the carpal tunnel, the interior carpal boundary (ICB), the exterior carpal boundary (ECB), and the wrist were disproportionately greater in the CTS patients. Among them, both the MN-to-ICB and MN-to-ECB ratios had fair to good diagnostic values (area under the curve = 0.725 and 0.794, respectively). Conclusions: These results highlight the utility of MRI-derived CSA measurements and ratios in identifying pathophysiological changes in CTS patients, particularly crowding of the MN inside the carpal tunnel. Further studies are recommended to refine MRI-based diagnostic protocols for CTS.

Advances in Carpal Tunnel Syndrome: Anatomy, Ultrasound Diagnostics and Modern Treatment Strategies - review

Carpal Tunnel Syndrome (CTS) is a prevalent condition characterized by compression of the median nerve within the carpal tunnel, leading to motor and sensory dysfunctions primarily in the hand. The advent of high-resolution ultrasound (US) has revolutionized the diagnostic approach to CTS, offering a non-invasive alternative to traditional nerve conduction studies (NCS). This review examines the anatomical foundations of CTS, explores the diagnostic value of ultrasound compared to NCS, and evaluates its role in guiding therapeutic interventions, both conservative and surgical. Recent studies highlight the growing importance of ultrasound in diagnosing CTS and tailoring individualized treatment strategies, with a focus on improving patient outcomes and reducing recovery times. The review also emphasizes advancements in ultrasound-guided surgical techniques, demonstrating improved efficacy and fewer complications in severe cases of CTS.

Impact of compressive neuropathy on peripapillary retinal nerve fiber layer thickness in pediatric patients after craniopharyngioma surgery

Impact of compressive neuropathy on peripapillary retinal nerve fiber layer thickness in pediatric patients after craniopharyngioma surgery

Pronator teres syndrome in association with compressive neuropathies on the upper limb. Serial cases and bibliographic review

Pronator teres syndrome in association with compressive neuropathies on the upper limb. Serial cases and bibliographic review

Carpal tunnel release surgery restores force control but not force coordination in CTS patients

Efficient manipulation of objects is crucial for daily interactions with the world. Compression neuropathies like carpal tunnel syndrome (CTS) can have detrimental effects on hand function, which can be improved by surgical intervention. Twelve patients with CTS grasped and lifted an instrumented handle while maintaining static equilibrium under different torque conditions. We compared fingertip forces and grip force variability across trials before and after surgery. Additionally, we evaluated the coordination of fingertip forces using a metric defined as synergy index to determine if there were improvements in coordination post-surgery. It was expected that there would be a decrease in fingertip forces and intertrial grip force variability indicative of recovery as well as an enhancement in synergy indices reflecting improved coordination. As expected, there was a decrease in the grip forces and intertrial variability of grip forces after surgery. However, the synergy indices were statistically similar before and after surgery, indicating that there was no change in neural strategies for coordination. Despite enhanced sensory conduction post-surgery, the central nervous system’s operational strategies for motor control remained unchanged. These findings suggest that while grip force regulation improves, the underlying coordination mechanisms do not adapt in response to the surgery. The findings of this study indicate that peripheral feedback does not modulate the synergies while performing a task, suggesting that neural coordination may not change with compression neuropathies or during recovery.

Infectious disease.

A young gentleman from Haiti presents with widespread erythematous nodules. He had joint pain affecting his elbows and wrists, and symptoms of median nerve entrapment.

The use of implanted port systems in the treatment of oncological chronic pain: case series

Cancer pain occurs in oncologic patients due to tissue damage, inflammation, nerve compression or the effects of treatment. Pain can significantly reduce the quality of life, but modern medicine offers effective approaches to its control. If pain relief is achieved only with high doses of opioids, the method of choice is interventional pain management procedures such as tunneled epidural catheters, fully implanted systems for intrathecal or epidural administration. Implantable port systems are an effective tool in the treatment of chronic cancer pain and provide convenient and long-term access to therapy. They allow the delivery of analgesics and other drugs directly to the spinal cord, minimizing side effects and improving the quality of life of patients. Implantable port systems significantly improve the quality of life of patients with chronic diseases or the need for regular treatment.

Compression of the Palmar Digital Nerve of the Index Finger by a Lipoma: A Case Report

Compression of the Palmar Digital Nerve of the Index Finger by a Lipoma: A Case Report

Hydrogen Peroxide Modulates the Timely Activation of Jun and Erk in Schwann Cells at the Injury Site and Is Required for Motor Axon Regeneration.

Peripheral nervous system (PNS) neurons, including motor neurons (MNs), possess a remarkable ability to regenerate and reinnervate target muscles following nerve injury. This process is orchestrated by a combination of intrinsic neuronal properties and extrinsic factors, with Schwann cells (SCs) playing a central role. Upon injury, SCs transition into a repair phenotype that allows axonal regeneration through molecular signaling and structural guidance. However, the identity of the SCs' reprogramming factors is only partially known. We previously identified hydrogen peroxide (H2O2) as an early and key driver of nerve repair, inducing gene expression rewiring in SCs to support nerve re-growth. In this study, we quantitatively assessed the role of H2O2 in the activation of key pro-regenerative signaling pathways in SCs following sciatic nerve compression, specifically the extracellular signal-regulated kinase 1/2 (ERK1/2) and c-Jun, which are essential for functional nerve recovery. Notably, we found that H2O2 neutralization does not impact degeneration, but it significantly affects the regenerative response. Collectively, our findings establish H2O2 as a promising regulator of the Schwann cell injury response at the injury site, linking oxidative signaling to the molecular mechanisms governing nerve regeneration.

Efficacy and Clinical Applicability of Impar Ganglion Block in the Treatment of Pudendal Neuralgia: A Systematic Review

Background/Objectives: Pudendal neuralgia (PN) is a debilitating chronic pain condition resulting from injury, inflammation, or entrapment of the pudendal nerve. It significantly affects patients’ quality of life and poses challenges to treatment due to its complex etiology. Conventional therapies often provide limited or temporary relief. The impar ganglion block (IGB) has emerged as a potential intervention for managing refractory pelvic pain syndromes. This systematic review aimed to evaluate the clinical efficacy, safety, and applicability of IGB in treating patients with PN. Methods: This systematic review evaluates the efficacy and clinical applicability of IGBs in treating PN. Following PRISMA-P 2020 guidelines, a systematic search was conducted in PubMed/MEDLINE, Embase, LILACS, and Cochrane Library. Eligible studies included RCTs, observational studies, and case series assessing pain reduction and quality of life post-IGB. Non-neuropathic pelvic pain studies were excluded. The ROBVIS tool assessed the risk of bias. Results: Of 306 articles screened, 16 met eligibility criteria. Studies showed that the IGB provides significant pain relief, particularly for refractory cases. Image-guided techniques enhanced precision and reduced complications. Combination therapies with corticosteroids yielded longer-lasting analgesia. However, methodological inconsistencies and varied patient selection limited generalizability. Conclusions: The IGB is a minimally invasive, effective option for managing PN. Further high-quality RCTs are needed to standardize protocols, optimize patient selection, and evaluate long-term efficacy. A multidisciplinary approach remains essential.

Evaluation of the Therapeutic Efficacy of Entrapment Neuropathy Unties (ENU) Pharmacopuncture in Neuropathic Pain Caused by Sciatic Nerve Ligation in Mice

Evaluation of the Therapeutic Efficacy of Entrapment Neuropathy Unties (ENU) Pharmacopuncture in Neuropathic Pain Caused by Sciatic Nerve Ligation in Mice

Arthroscopic Suprascapular Nerve Decompression: A Technique Video

Background: Suprascapular neuropathy is an uncommon but treatable cause of shoulder pain and dysfunction. The tortuous course of the suprascapular nerve puts it at risk for entrapment, particularly at the suprascapular and spinoglenoid notches. This video presents a reproducible method for suprascapular nerve decompression at the suprascapular notch. Indications: Massive rotator cuff tears, compressive masses, or ligament hypertrophy warrants prompt intervention to prevent subsequent denervation in the face of suprascapular neuropathy. In the absence of these pathologies, a trial of conservative management is advised. Patients who have unsuccessful conservative management and evidence of worsening weakness, atrophy, and denervation by electromyography are indicated for surgical intervention. Technique Description: Standard posterior, anterior, lateral, and anterolateral portals are established. The subdeltoid space is dissected following the coracoacromial (CA) ligament to the base of the coracoid to identify the transverse scapular ligament. In the presented case, the CA ligament has been debrided from a previous surgery, so an intra-articular approach was employed, opening the rotator interval to reach the base of the coracoid. A Neviaser portal is made for blunt dissection around the suprascapular notch, with care taken to protect the neurovasculature. A second medial Neviaser portal is used to pass a Kerrison to release the transverse scapular ligament. Nerve adhesions are then gently released with a probe. Results: A systematic review of 276 suprascapular nerve decompressions demonstrated good outcomes in terms of pain relief and function, and all athletes in the review returned to sport. A case series of 112 arthroscopic decompressions at the suprascapular notch found that patients achieved significant improvement in pain and strength, and none resulted in serious complications. These outcome studies support a level 4 video publication level of evidence. Discussion/Conclusion: The presented arthroscopic decompression technique treats suprascapular nerve entrapment at the suprascapular notch. Patients can expect to achieve a satisfactory outcome. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

143. Management of Compression Neuropathies Associated with Vascular Malformations

143. Management of Compression Neuropathies Associated with Vascular Malformations

Temporal and spatial expression of Phosphodiesterase-4B after sciatic nerve compression in rats and its mechanism of action on sciatic nerve repair.

Temporal and spatial expression of Phosphodiesterase-4B after sciatic nerve compression in rats and its mechanism of action on sciatic nerve repair.

Hyaluronic Acid-Based Therapy for Alleviating Early Lipid Peroxidation in Peripheral Nerve Compression Injury Repair.

Hyaluronic Acid-Based Therapy for Alleviating Early Lipid Peroxidation in Peripheral Nerve Compression Injury Repair.

Damage to the peripheral nervous system in rheumatoid arthritis: a review of current data, diagnostic criteria, and therapeutic strategies

Aim of the review — to summarize current data on the pathogenesis, clinical manifestations, diagnosis, and treatment of peripheral neuropathy in patients with rheumatoid arthritis. Peripheral neuropathy (PN) is a common complication of rheumatoid arthritis (RA), significantly impairing patients’ quality of life and leading to disability. This article provides an overview of current data on the pathogenesis, clinical manifestations, diagnosis, and treatment of PN in RA. Mechanisms involved in the pathogenesis of PN include vasculitis, autoimmune responses, neurogenic inflammation, and nerve compression. Clinical manifestations of PN are diverse and include sensory, motor, and autonomic disorders. Diagnosis involves clinical examination, electroneuromyography, ultrasound, magnetic resonance imaging (MRI), and nerve biopsy. MRI, including magnetic resonance neurography, functional MRI, and MRI spectroscopy, allows visualization of affected nerves, assessment of their structure and function, as well as detection of brain changes associated with pain. Treatment of PN in RA includes control of the underlying disease with disease-modifying antirheumatic drugs (DMARDs) and biologic therapy, as well as symptomatic treatment of neurological manifestations. In cases of vasculitic neuropathy, more aggressive therapy with high doses of glucocorticoids and/or cytotoxic drugs may be required. Conservative methods and surgical intervention are used to treat compressive neuropathies. Additional therapy includes drugs affecting neurotransmitters, B vitamins, and α-lipoic acid. In recent years, data have emerged on the effectiveness of palmitoylethanolamide and pterostilbene in the treatment of PN in RA, but further research is needed to confirm their efficacy and safety. Despite the progress made in understanding PN in RA, questions remain that require further study, including the development of more effective treatments and the identification of predictors of the development of neuropathy.

Deep Learning Based Image Segmentation for Diagnosis of Spondylolisthesis from Lumbar Spine X-RAY

Abstract: Spondylolisthesis is a condition of Spine which occurs due to slippage of vertebrae. which can causepain and resultsin limited mobility and nerve compression. Accurate detection in early stages important for prevention of further complications. Traditional methos heavily depends on human examination of X-ray images, which can cause manual errors. To improve the detection of spondylolisthesis in X-ray images we used deep learning techniques. YOLO (you only look once) is known for itsreal time processing capability and high precision, works faster, detects and segments in one step based on percentage of vertebral slippage, and gives more accurate results. We compared the results obtained by YOLOV8 and YOLOV11. This study supports the use of deep learning techniques to assist medical professionals in making more accurate assessments.

Global trends in cervical spondylosis research: a bibliometric analysis based on the Web of Science

ObjectiveWe aim to analyze the development trends in cervical spondylosis research and guide future studies. Cervical spondylosis, a standard neck disorder characterized by pain, nerve compression, and spondylosis, is highly prevalent, particularly among older individuals, due to the extensive use of electronic devices. Since treatment options are limited and surgery is considered a last resort, it is crucial to explore the current research status and identify areas for further investigation.MethodWe conducted a bibliometric analysis of academic articles on cervical spondylosis published between 1980 and 2022. The analysis involved utilizing the Web of Science database and employing R software and a VOS viewer.ResultsOur analysis revealed that neurosciences and neurology were the primary research focus, with participation from 62 countries. China had the highest number of publications, while the USA received the most citations. The Rothman Institute emerged as the most cited institution in neck pain research. The journal “Spine” had the highest publication count. Among authors, Mummaneni P. V. was the most cited, and Liu H. had the highest number of publications. The keyword “Spine” was the most frequently used.ConclusionOur bibliometric study summarized the current research status of cervical spondylosis. Further investigations are warranted in diagnosis, treatment, prevention, non-surgical interventions, and rehabilitation. Promising areas of interest include artificial cervical discs, gene therapy, and stem cell therapy. Our study provides a framework for enhancing cervical spondylosis’s diagnosis and treatment by addressing existing literature gaps.