Introduction Peripheral nerve injury (PNI) imposes significant burdens, requiring therapies targeting both mechanical compression and inflammatory pathophysiology. While neurolysis addresses extrinsic compression and methylcobalamin promotes intrinsic nerve repair, their combined potential is underexplored. This study compared the efficacy of neurolysis monotherapy, methylcobalamin monotherapy, and combination therapy across functional, electrophysiological, and inflammatory outcomes in PNI. Methods Ninety PNI patients were randomized to three groups ( n = 30/group): neurolysis alone, methylcobalamin alone (0.5 mg tid), or combination therapy. Outcomes at 60 days comprised functional recovery (Carroll Scale), nerve conduction velocities (MCV, SCV, AMP, LAT), joint mobility (AROM/PROM), pain severity (Global Pain Scale), and serum cytokines (NF-κB, TNF-α, IL-6 via ELISA). Results The combination group demonstrated significantly higher total therapeutic efficacy (86.67%) compared to neurolysis alone (50.00%) and methylcobalamin alone (53.33%; P 0.05). All groups showed significant post-treatment improvements in nerve conduction velocities, joint mobility parameters, pain scores, and inflammatory cytokine levels ( P 0.05). However, combination therapy yielded superior outcomes: it produced the greatest improvements in active and passive range of motion, the most significant reductions in pain scores across all assessed domains, and the lowest post-treatment levels of inflammatory cytokines (NF-κB, TNF-α, IL-6; P 0.05 versus either monotherapy). Discussion The combination of neurolysis and methylcobalamin synergistically enhances functional recovery, nerve conduction, joint mobility, pain relief, and anti-inflammatory effects in PNI, demonstrating superior clinical efficacy compared to either treatment administered alone.
Hu et al. (Wed,) studied this question.