{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T22:56:41Z","timestamp":1794265001863,"version":"4.9.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T00:00:00Z","timestamp":1566345600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurosurg.","NEUROS"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Patients with severe cubital tunnel syndrome often have poor functional recovery with conventional surgical treatment. Postsurgical electrical stimulation (PES) has been shown to enhance axonal regeneration in animal and human studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To determine if PES following surgery for severe cubital tunnel syndrome would result in better outcomes compared to surgery alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with severe cubital tunnel syndrome in this randomized, double-blind, placebo-controlled trial were randomized in a 1:2 ratio to the control or stimulation groups. Control patients received cubital tunnel surgery and sham stimulation, whereas patients in the stimulation group received 1-h of 20 Hz PES following surgery. Patients were assessed by a blinded evaluator annually for 3 yr. The primary outcome was motor unit number estimation (MUNE) and secondary outcomes were grip and key pinch strength and McGowan grade and compound muscle action potential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      A total of 31 patients were enrolled: 11 received surgery alone and 20 received surgery and PES. Three years following surgery, MUNE was significantly higher in the PES group (176\u00a0\u00b1\u00a023, mean\u00a0+\u00a0SE) compared to controls (88\u00a0\u00b1\u00a011,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.05). The mean gain in key pinch strength in the PES group was almost 3 times greater than in the controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.05). Similarly, other functional and physiological outcomes showed significantly greater improvements in the PES group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>PES enhanced muscle reinnervation and functional recovery following surgery for severe cubital tunnel syndrome. It may be a clinically useful adjunct to surgery for severe ulnar neuropathy, in which functional recovery with conventional treatment is often suboptimal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyz322","type":"journal-article","created":{"date-parts":[[2019,7,30]],"date-time":"2019-07-30T07:10:13Z","timestamp":1564470613000},"page":"769-777","source":"Crossref","is-referenced-by-count":100,"title":["Postsurgical Electrical Stimulation Enhances Recovery Following Surgery for Severe Cubital Tunnel Syndrome: A Double-Blind Randomized Controlled Trial"],"prefix":"10.1227","volume":"86","author":[{"given":"Hollie A","family":"Power","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Morhart","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaret L","family":"Olson","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K Ming","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"1-2","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.jns.2005.02.010","article-title":"Incidence of ulnar neuropathy at the elbow in the province of Siena (Italy)","volume":"234","author":"Mondelli","year":"2005","journal-title":"J Neurol Sci"},{"issue":"12","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"2591","DOI":"10.2106\/JBJS.G.00183","article-title":"Anterior transposition compared with simple decompression for treatment of cubital tunnel syndrome. A meta-analysis of randomized, controlled trials","volume":"89","author":"Zlowodzki","year":"2007","journal-title":"J Bone Joint Surg Am"},{"issue":"12","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1016\/j.jhsa.2013.09.017","article-title":"Minimum 6-year follow-up after ulnar nerve decompression and submuscular transposition for primary entrapment","volume":"38","author":"Zimmerman","year":"2013","journal-title":"J Hand Surg [Am]"},{"issue":"1-2","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/BF02740621","article-title":"The cellular and molecular basis of peripheral nerve regeneration","volume":"14","author":"Fu","year":"1997","journal-title":"Mol Neurobiol"},{"issue":"2","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1016\/S0014-4886(03)00183-3","article-title":"Glial cell line-derived neurotrophic factor and brain-derived neurotrophic factor sustain the axonal regeneration of chronically axotomized motoneurons in vivo","volume":"183","author":"Boyd","year":"2003","journal-title":"Exp Neurol"},{"issue":"5","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"3886","DOI":"10.1523\/JNEUROSCI.15-05-03886.1995","article-title":"Contributing factors to poor functional recovery after delayed nerve repair: prolonged denervation","volume":"15","author":"Fu","year":"1995","journal-title":"J Neurosci"},{"issue":"7","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"2602","DOI":"10.1523\/JNEUROSCI.20-07-02602.2000","article-title":"Brief electrical stimulation promotes the speed and accuracy of motor axonal regeneration","volume":"20","author":"Al Majed","year":"2000","journal-title":"J Neurosci"},{"issue":"15","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"6631","DOI":"10.1523\/JNEUROSCI.22-15-06631.2002","article-title":"Electrical stimulation promotes motoneuron regeneration without increasing its speed or conditioning the neuron","volume":"22","author":"Brushart","year":"2002","journal-title":"J Neurosci"},{"issue":"1","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.expneurol.2005.02.007","article-title":"Electrical stimulation restores the specificity of sensory axon regeneration","volume":"194","author":"Brushart","year":"2005","journal-title":"Exp Neurol"},{"issue":"2","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/j.expneurol.2007.01.040","article-title":"Electrical stimulation promotes sensory neuron regeneration and growth-associated gene expression","volume":"205","author":"Geremia","year":"2007","journal-title":"Exp Neurol"},{"issue":"10","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"e110174","DOI":"10.1371\/journal.pone.0110174","article-title":"Delayed nerve stimulation promotes axon-protective neurofilament phosphorylation, accelerates immune cell clearance and enhances remyelination in vivo in focally demyelinated nerves","volume":"9","author":"McLean","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.expneurol.2009.09.020","article-title":"Brief post-surgical electrical stimulation accelerates axon regeneration and muscle reinnervation without affecting the functional measures in carpal tunnel syndrome patients","volume":"223","author":"Gordon","year":"2010","journal-title":"Exp Neurol"},{"issue":"6","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1002\/ana.24397","article-title":"Electrical stimulation enhances sensory recovery: A randomized controlled trial","volume":"77","author":"Wong","year":"2015","journal-title":"Ann Neurol"},{"issue":"1","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40463-017-0244-9","article-title":"Intraoperative Brief Electrical Stimulation of the Spinal Accessory Nerve (BEST SPIN) for prevention of shoulder dysfunction after oncologic neck dissection: a double-blinded, randomized controlled trial","volume":"47","author":"Barber","year":"2018","journal-title":"J Otolaryngol Head Neck Surg"},{"issue":"3","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1302\/0301-620X.32B3.293","article-title":"The results of transposition of the ulnar nerve for traumatic ulnar neuritis","volume":"32-B","author":"McGowan","year":"1950","journal-title":"J Bone Joint Surg Br"},{"issue":"2","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/0363-5023(89)90003-8","article-title":"Ulnar neuropathy at the elbow: results of medial epicondylectomy","volume":"14","author":"Goldberg","year":"1989","journal-title":"J Hand Surg Am"},{"issue":"6","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1002\/mus.24442","article-title":"Motor unit number estimation: a technology and literature review","volume":"50","author":"Gooch","year":"2014","journal-title":"Muscle Nerve"},{"issue":"1","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cct.2005.08.003","article-title":"The use of unequal randomisation ratios in clinical trials: a review","volume":"27","author":"Dumville","year":"2006","journal-title":"Contemp Clin Trials"},{"key":"bib19-20231011","first-page":"S171","article-title":"Guidelines in electrodiagnostic medicine. Practice parameter for electrodiagnostic studies in ulnar neuropathy at the elbow","volume":"8","year":"1999","journal-title":"Muscle Nerve Suppl"},{"issue":"10","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1179\/016164110X12760028832470","article-title":"Motor unit number estimation in transected peripheral nerves","volume":"32","author":"Oge","year":"2010","journal-title":"Neurol Res"},{"issue":"6","key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"816","DOI":"10.5535\/arm.2011.35.6.816","article-title":"Motor unit number estimation and motor unit action potential analysis in carpal tunnel syndrome","volume":"35","author":"Sohn","year":"2011","journal-title":"Ann Rehabil Med"},{"issue":"3","key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/j.1469-7793.1998.909bm.x","article-title":"Incomplete rematching of nerve and muscle properties in motor units after extensive nerve injuries in cat hindlimb muscle","volume":"509","author":"Rafuse","year":"1998","journal-title":"J Physiol"},{"issue":"1","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"eaau2956","DOI":"10.1126\/sciadv.aau2956","article-title":"Peripheral nerve transfers change target muscle structure and function","volume":"5","author":"Bergmeister","year":"2019","journal-title":"Sci Adv"},{"key":"bib24-20231011","first-page":"323","article-title":"Serial estimation of motor unit numbers using an implantable system following nerve injury and repair in rats","volume":"2016","author":"Willand","year":"2016","journal-title":"Conf Proc IEEE Eng Med Biol Soc"},{"issue":"3","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1002\/mus.26391","article-title":"A modified multiple point stimulation method for motor unit number estimation of the hypothenar muscles","volume":"59","author":"Hachisuka","year":"2019","journal-title":"Muscle Nerve"},{"issue":"6","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1097\/00004691-199511000-00004","article-title":"Methods for estimating the numbers of motor units in human muscles","volume":"12","author":"Doherty","year":"1995","journal-title":"J Clin Neurophysiol"},{"issue":"5","key":"bib27-20231011","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.MLR.0000062554.74615.4C","article-title":"Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation","volume":"41","author":"Norman","year":"2003","journal-title":"Med Care"},{"issue":"5","key":"bib28-20231011","doi-asserted-by":"crossref","first-page":"722","DOI":"10.3171\/jns.1998.89.5.0722","article-title":"Surgical management of ulnar nerve compression at the elbow: an analysis of the literature","volume":"89","author":"Bartels","year":"1998","journal-title":"J Neurosurg"},{"issue":"1","key":"bib29-20231011","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1227\/01.NEU.0000145854.38234.81","article-title":"Simple decompression versus anterior submuscular transposition of the ulnar nerve in severe cubital tunnel syndrome: a prospective randomized study","volume":"56","author":"Gervasio","year":"2005","journal-title":"Neurosurgery"},{"issue":"3","key":"bib30-20231011","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1007\/s00701-017-3086-3","article-title":"Muscular atrophy in severe cases of cubital tunnel syndrome: prognostic factors and outcome after surgical treatment","volume":"159","author":"Bruder","year":"2017","journal-title":"Acta Neurochir."},{"key":"bib31-20231011","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.expneurol.2015.03.022","article-title":"Brief electrical stimulation improves nerve regeneration after delayed repair in Sprague Dawley rats","volume":"269","author":"Elzinga","year":"2015","journal-title":"Exp Neurol"},{"issue":"1","key":"bib32-20231011","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.expneurol.2007.08.005","article-title":"One hour electrical stimulation accelerates functional recovery after femoral nerve repair","volume":"208","author":"Ahlborn","year":"2007","journal-title":"Exp Neurol"},{"issue":"2","key":"bib33-20231011","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1002\/dneu.20339","article-title":"Electrical stimulation promotes peripheral axon regeneration by enhanced neuronal neurotrophin signaling","volume":"67","author":"English","year":"2007","journal-title":"Devel Neurobio"},{"key":"bib34-20231011","doi-asserted-by":"crossref","first-page":"4381","DOI":"10.1111\/j.1460-9568.2000.01341.x","article-title":"Electrical stimulation accelerates and increases expression of BDNF and trkB mRNA in regenerating rat femoral motoneurons","volume":"12","author":"Al Majed","year":"2000a","journal-title":"Eur J Neurosci"},{"issue":"4","key":"bib35-20231011","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1089\/neu.2008.0758","article-title":"Electrical stimulation promotes motor nerve regeneration selectivity regardless of end-organ connection","volume":"26","author":"Wang","year":"2009","journal-title":"J Neurotrauma"},{"issue":"1","key":"bib36-20231011","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.expneurol.2007.11.007","article-title":"Electrical stimulation of intact peripheral sensory axons in rats promotes outgrowth of their central projections","volume":"210","author":"Udina","year":"2008","journal-title":"Exp Neurol"},{"issue":"3","key":"bib37-20231011","first-page":"379","article-title":"Electrical stimulation accelerates and enhances expression of regeneration-associated genes in regenerating rat femoral motoneurons","volume":"24","author":"Al Majed","year":"2004","journal-title":"Cell Mol Biol"},{"issue":"3","key":"bib38-20231011","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1111\/ejn.13005","article-title":"Strategies to promote peripheral nerve regeneration: electrical stimulation and\/or exercise","volume":"43","author":"Gordon","year":"2016","journal-title":"Eur J Neurosci"},{"issue":"5","key":"bib39-20231011","doi-asserted-by":"crossref","first-page":"3876","DOI":"10.1523\/JNEUROSCI.15-05-03876.1995","article-title":"Contributing factors to poor functional recovery after delayed nerve repair: prolonged axotomy","volume":"15","author":"Fu","year":"1995","journal-title":"J Neurosci"},{"issue":"4","key":"bib40-20231011","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1046\/j.1460-9568.2002.01891.x","article-title":"A dose-dependent facilitation and inhibition of peripheral nerve regeneration by brain-derived neurotrophic factor","volume":"15","author":"Boyd","year":"2002","journal-title":"Eur J Neurosci"},{"issue":"7","key":"bib41-20231011","first-page":"CD006839","article-title":"Treatment for ulnar neuropathy at the elbow","volume":"11","author":"Caliandro","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"bib42-20231011","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.jhsa.2008.03.006","article-title":"Simple decompression versus anterior subcutaneous and submuscular transposition of the ulnar nerve for cubital tunnel syndrome: a meta-analysis","volume":"33","author":"Macadam","year":"2008","journal-title":"J Hand Surg Am"},{"key":"bib43-20231011","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.clineuro.2014.08.005","article-title":"Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis","volume":"126","author":"Chen","year":"2014","journal-title":"Clin Neurol Neurosurg"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/advance-article-pdf\/doi\/10.1093\/neuros\/nyz322\/29193049\/nyz322.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyz322","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:51:50Z","timestamp":1786121510000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/neuros\/nyz322"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,20]]},"references-count":43,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyz322","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,20]]}}}