Electrophysiological Changes in Patients with Carpal Tunnel Syndrome after Open Carpal Tunnel Release
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting the upper limbs. Various treatment methods exist for this disease, but only a few reports have compared the effects of various treatments using objective indicators. This study analyzed the changes in electrophysiological parameters after carpal tunnel release.Methods: In patients planning to undergo surgical treatment for CTS, electrophysiological studies, including nerve conduction studies and electromyography (EMG), of both upper extremities were performed before and 6 to 8 weeks after mini-open transverse carpal ligament release and median nerve neurolysis.Results: After surgical intervention, the onset latency and amplitude of the sensory nerve action potential (SNAP) and the onset latency of the compound muscle action potential (CMAP) of the median nerve improved. Additionally, the grade of abnormal spontaneous activity in needle EMG of the abductor pollicis brevis (APB) and the severity of the electrodiagnostic study results significantly decreased after the intervention compared to the initial evaluation.Conclusion: This study shows that the onset latency of SNAP and CMAP, the amplitude of SNAP of the median nerve, and EMG findings in the APB can be useful electrodiagnostic parameters for postoperative monitoring in CTS patients.
Abstract
Objective: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy affecting the upper limbs. Various treatment methods exist for this disease, but only a few reports have compared the effects of various treatments using objective indicators. This study analyzed the changes in electrophysiological parameters after carpal tunnel release.Methods: In patients planning to undergo surgical treatment for CTS, electrophysiological studies, including nerve conduction studies and electromyography (EMG), of both upper extremities were performed before and 6 to 8 weeks after mini-open transverse carpal ligament release and median nerve neurolysis.Results: After surgical intervention, the onset latency and amplitude of the sensory nerve action potential (SNAP) and the onset latency of the compound muscle action potential (CMAP) of the median nerve improved. Additionally, the grade of abnormal spontaneous activity in needle EMG of the abductor pollicis brevis (APB) and the severity of the electrodiagnostic study results significantly decreased after the intervention compared to the initial evaluation.Conclusion: This study shows that the onset latency of SNAP and CMAP, the amplitude of SNAP of the median nerve, and EMG findings in the APB can be useful electrodiagnostic parameters for postoperative monitoring in CTS patients.
참고문헌 (18)
- Wipperman J, "Carpal tunnel syndrome : diagnosis and management", Am Fam Physician, 94, pp.993~999 (2016)
- Aroori S, "Carpal tunnel syndrome", Ulster Med J, 77, pp.6~17 (2008)
- Chen YT, "Review of ultrasonography in the diagnosis of carpal tunnel syndrome and a proposed scanning protocol", J Ultrasound Med, 35, pp.2311~2324 (2016)
- Pimentel BF, "Effectiveness of ultrasonography and nerve conduction studies in the diagnosing of carpal tunnel syndrome : clinical trial on accuracy", BMC Musculoskelet Disord, 19, pp.115~ (2018)
- Werner RA, "Electrodiagnostic evaluation of carpal tunnel syndrome", Muscle Nerve, 44, pp.597~607 (2011)
- Petrover D, "Treatment of carpal tunnel syndrome : from ultrasonography to ultrasound guided carpal tunnel release", Joint Bone Spine, 85, pp.545~552 (2018)
- Shi Q, "Comparison of the short-term and long-term effects of surgery and nonsurgical intervention in treating carpal tunnel syndrome : a systematic review and meta-analysis", Hand(N Y), 15, pp.13~22 (2020)
- Celik G, "Effects of two different treatment techniques on the recovery parameters of moderate carpal tunnel syndrome : a six-month follow-up study", J Clin Neurophysiol, 33, pp.166~170 (2016)
- Jørgsholm P, "Outcome of carpal tunnel release in patients with normal nerve conduction studies", J Orthop Sci, 26, pp.798~803 (2021)
- Zhang S, "The effectiveness of ultrasound-guided steroid injection combined with miniscalpel-needle release in the treatment of carpal tunnel syndrome vs. steroid injection alone: a randomized controlled study", Biomed Res Int, 2019, pp.9498656~ (2019)
- Osiak K, "Electrodiagnostic studies in the surgical treatment of carpal tunnel syndrome-A systematic review", J Clin Med, 10, pp.2691~ (2021)
- El-Hajj T, "Changes in electrophysiological parameters after surgery for the carpal tunnel syndrome", J Clin Neurophysiol, 27, pp.224~226 (2010)
- Ginanneschi F, "Short-term electrophysiological conduction change in median nerve fibres after carpal tunnel release", Clin Neurol Neurosurg, 110, pp.1025~1030 (2008)
- Park D, "Electrodiagnostic, sonographic, and clinical features of carpal tunnel syndrome with bifid median nerve", J Pain Res, 14, pp.1259~1269 (2021)
- Hawker GA, "Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)", Arthritis Care Res (Hoboken), 63(Suppl 11), pp.S240~S252 (2011)
- Lama M, "Carpal tunnel release in patients with negative neurophysiological examinations: clinical and surgical findings", Neurosurgery, 65(4 Suppl), pp.A171~A173 (2009)
- Dagtas MZ, "Long-term outcome of electrodiagnostic values and symptom improvement after carpal tunnel release : a retrospective cohort study", J Hand Surg Am, 47, pp.727~735 (2022)
- Meyers A, "Bassiri Gharb B : A systematic review of the outcomes of carpal ligament release in severe carpal tunnel syndrome", J Hand Surg Am (2022)[DOI]
