Comparative study of median nerve decompression in treatment of carpal tunnel syndrome caused by different etiologies
10.3760/cma.j.cn115354-20220407-00213
- VernacularTitle:正中神经减压术治疗不同病因所致腕管综合征的对比研究
- Author:
Wenqiang YANG
1
;
Qi WANG
;
Yanbing YU
;
Li ZHANG
Author Information
1. 中日友好医院神经外科，北京 100029
- Keywords:
Carpal tunnel syndrome;
Median nerve entrapment;
Diabetes mellitus;
Dialysis
- From:
Chinese Journal of Neuromedicine
2022;21(6):606-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of microsurgical decompression in carpal tunnel syndrome (CTS) caused by different etiologies.Methods:A retrospective analysis was performed. The clinical data of 54 patients with CTS, admitted to our hospital from January 2018 to December 2018, were chosen; 20 patients were with idiopathic CTS (20 laterals), 16 patients were with diabetic-related CTS (26 laterals), and 18 patients were with dialysis-related CTS (22 laterals). All patients were treated with median nerve microsurgical decompression. Before surgery and 2 weeks after surgery, Boston carpal tunnel questionnaire (BCTQ) was used to evaluate the symptom and function scores, and median nerve conduction velocity was detected.Results:Intraoperatively, there was definite nerve entrapment in all three groups, but the neuropathy scopes in the diabetic-related CTS group were more extensive than those in the idiopathic group and dialysis-related CTS group. The postoperative BCTQ symptom and functional scores in the three groups were significantly decreased as compared with the preoperative ones ( P<0.05); however, there were no significant differences among the three groups in the postoperative BCTQ symptom and functional scores ( P>0.05). The postoperative sensory nerve conduction velocity and motor nerve conduction velocity in the three groups were significantly improved as compared with the preoperative ones ( P<0.05). There were significant differences among the three groups in postoperative sensory nerve conduction velocity and motor nerve conduction velocity ( P<0.05); the sensory nerve conduction velocity and motor nerve conduction velocity in the diabetic-related CTS group were significantly decreased as compared with those in idiopathic CTS group, and the sensory nerve conduction velocity and motor nerve conduction velocity in dialysis-related CTS group were significantly increased as compared with those in the diabetic-related CTS group ( P<0.05). The main surgical complications in three groups included poor incision healing: the incidence was 5% (1/20) in the idiopathic group, 15.3% (4/26) in the diabetic-related CTS group, and 18.1% (4/22) in dialysis-related CTS group, without significant differences ( χ2=1.755, P=0.416). Conclusion:Microsurgical decompression can achieve satisfactory results in the treatment of dialysis-related CTS, diabetes-related CTS and idiopathic CTS.
