Artikel
Intraoperative NCS During Open Carpal Tunnel Release: A Pilot Study
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Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Operative management of carpal tunnel syndrome (CTS) involves release of the transverse carpal ligament (TCL) and often the volar antebrachial fascia (VAF). Evidence of a difference between TCL and TCL+VAF release is lacking. We aimed to conduct a pilot study to measure changes of intraoperative nerve conduction velocity (NCV) after CTS surgery and compare outcomes of variable degrees of decompression.
Methods: Patients aged 18-65 years diagnosed with idiopathic CTS and who failed conservative management were included in this study. Cases were excluded if they had prior surgical release, had diabetes, acute CTS, trauma, or cervical spine radiculopathy. Outcomes included motor and sensory amplitude and latency. Electrodes were placed on the skin intraoperatively, along the abductor pollicis brevis, index finger, and forearm. TCL and VAF release were performed in the usual manner. Outcome data were recorded at baseline, after TCL release, and after TCL+VAF release. A single-tail t-test was then performed for analysis (Figure 1 [Fig. 1], Table 1 [Tab. 1]).
10 patients were included in this study. From baseline to TCL+VAF release, mean motor amplitude, mean motor latency, mean sensory amplitude and mean sensory latency decreased (p>0.05). There were no statistically significant differences in mean sensory or motor function between TCL and TCL+VAF release.
The lack of significant findings suggests that NCV may not be useful for assessing intraoperative improvement. As a pilot study, we highlight the need for future research in the form of case-control studies to determine the utility of intraoperative NCV. These studies should be conducted with larger numbers of patients and multiple hand specialists.