Comparative Efficacy of Surgical and Non-surgical Treatments for Peripheral Nerve Injuries: A Systematic Review

Introduction: Peripheral nerve injuries (PNIs) can impair motor and sensory functions. This systematic review assessed the comparative efficacy of surgical and non-surgical treatments for PNIs.

Methods: A comprehensive search of PubMed and Embase identified 827 articles; 135 were reviewed in detail, with 68 meeting full inclusion criteria. Data from 60 studies were extracted, covering RCTs, cohort studies, and comparative analyses. Outcomes included motor recovery and pain reduction.

Results: Surgical interventions, such as direct nerve repair, showed significant improvements in motor function, with 83% achieving MRC grade 3 or higher. A study (n=29) reported a 2.5-point MRC score increase (p < 0.01). Sensory recovery, assessed via EMG, showed a 30% mean improvement (p < 0.05). Pain scores in surgical groups decreased from 4.2 ± 2.5 to 1.9 ± 2.4 on the VAS (p < 0.001). Non-surgical treatments provided moderate benefits, with approximately 1.5-point VAS reductions but less sustained long-term outcomes. Follow-ups, ranging up to 11.5 years, confirmed the durability of surgical results.

Conclusion : Surgical treatments yield superior long-term functional outcomes compared to non-surgical approaches, which are beneficial as adjuncts. Further long-term studies are needed to refine treatment strategies.