scholarly journals Electrodiagnostic Studies in the Surgical Treatment of Carpal Tunnel Syndrome—A Systematic Review

2021 ◽  
Vol 10 (12) ◽  
pp. 2691
Author(s):  
Katarzyna Osiak ◽  
Agata Mazurek ◽  
Przemysław Pękala ◽  
Mateusz Koziej ◽  
Jerzy A. Walocha ◽  
...  

The aim of our paper was to provide comprehensive data on the role of electrodiagnostic (EDX) studies in the surgical treatment of carpal tunnel syndrome (CTS). An extensive search was conducted through the major electronic database to identify eligible articles. Data extracted included grade of CTS based on neurophysiological testing, preoperative data of EDX studies, time of complete or partial resolution after surgery, postoperative Boston carpal tunnel questionnaire (CTQ) scores, age, sex, intraoperative and postoperative data of EDX studies, time to complete or partial resolution of symptoms, and number of patients without postsurgical improvement. Our main findings revealed that that electrodiagnostic testing is still a powerful tool for diagnosis of CTS. Moreover, it can also detect other pathologies. EDX testing provides a quantitative measure of the physiological function of the median nerve, which may be used to guide surgical treatment. Thirdly, when the outcome of surgery is unsatisfactory, NCS can assist in determining the reason for failure.

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Mohamed Abdelraouf ◽  
Amal Ibrahim Ahmed ◽  
Nouran Abdelrahman Elghitany

Abstract Background Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome. It is caused by compression of the median nerve as it passes through the carpal tunnel in the wrist. The diagnosis of CTS is based on a combination of characteristic symptoms and electrophysiologic abnormalities. Electrodiagnostic testing (EDT) is uncomfortable for patients, time consuming and expensive. Objective To evaluate the role of greyscale and strain elastography ultrasound imaging in diagnosing patients with CTS and controls in comparison with nerve conductive studies. Patients and Methods Type of Study: Descriptive, prospective study. Study Setting: The study will be conducted at Ain Shams University Hospitals, Radiodiagnosis department. Study Period: 6 months. Study Population: Patients with carpal tunnel syndrome diagnosed clinically and underwent nerve conduction velocity study. Results In this study 7 wrists were diagnosed with mild CTS, 5 wrists demonstrated moderate CT, whereas only 3 wrists revealed severe CTS. The mean CSA would have increased if the number of cases with severe CTS had been higher. CSA of the median nerve has been reported to increase with the severity of entrapment. The cut off point of the average CSA to differentiate between cases and controls was found > 8 with sensitivity of 93.33%, specificity of 80% and area under curve (AUC) of 91.3% while the best cut off point for Elasto score was found > 1 with sensitivity of 86.6%, specificity of 80% and area under curve (AUC) of 93.3%. Conclusion We concluded that sonoelastography is a sensitive tool for prediction of CTS and it’s severity in correlation to NCV.


2019 ◽  
Vol 48 (1) ◽  
pp. 030006051987808
Author(s):  
José Dinis Carmo

Objective To describe a new mini-invasive surgical technique for carpal tunnel release and to present clinical findings associated with using this technique. Methods Patients with idiopathic carpal tunnel syndrome without prior surgical treatment, who underwent a new minimally-invasive surgical technique using a specific surgical tool-kit developed by the author, were included. Prospective data were collected, including preoperative electrodiagnostic testing. The subjective condition of all patients was evaluated pre- and postoperatively with a five-level Likert-type scale (LS) and muscular strength was tested using a JAMAR dynamometer and pinch gauge. Results A total of 116 patients (157 hands/cases) underwent surgery performed by the author, and were followed for a mean of 40 months (range, 6 months–7 years). Of these, preoperative electrodiagnostic testing was performed in 112 patients (96.6%). No significant complications were reported. By three months, patients reported that they were satisfied or very satisfied in 147/149 cases (98.7%; LS grade I and II). Strength recovery at three months, based on the average of four measures, was 99.17% (range, 97.43–100.97%). Conclusions The described technique is minimally invasive, safe and simple to perform, and provides good results.


2016 ◽  
Vol 35 (6) ◽  
pp. 413-417 ◽  
Author(s):  
J.J. Hidalgo Diaz ◽  
S.S. Botero ◽  
P. Vernet ◽  
C. Aguerre ◽  
S. Facca ◽  
...  

2000 ◽  
Vol 8 (2) ◽  
pp. 19-25 ◽  
Author(s):  
Masato Okada ◽  
Osamu Tsubata ◽  
Sadayuki Yasumoto ◽  
Norihiko Toda ◽  
Tadami Matsumoto

Author(s):  
Ahmed M. Ahmed ◽  
Osama G. Hassan ◽  
Ahmed A. Khalifa

Abstract Background Carpal tunnel syndrome (CTS) is a common upper limb entrapment neuropathy; severe cases are treated surgically and mild to moderate can be managed conservatively. The purpose of this systematic review and meta-analysis was to define the efficacy of gabapentin as an adjuvant to splinting in the treatment of mild to moderate CTS. Methods A systematic search through 13 databases, randomized clinical trials (RCTs) reporting the use of gabapentin with splinting in CTS were included and analyzed. Results Three RCTs including 170 patients were eligible. There was no significant difference between gabapentin plus splinting and splinting alone in 5 measured parameters: (1) Symptom Severity Scale (SSS) [MD (95% CI) = − 0.76 (− 2.46–0.93), p = 0.378], (2) Functional Status Scale (FSS) [MD (95% CI) = − 0.23 (− 1.40–0.94), p = 0.701], (3) visual analogue scale (VAS) to assess pain [MD (95% CI) = − 0.6 (− 1.47–0.27), p = 0.174], (4) Grip strength [MD (95% CI) = − 0.11 (− 0.70–0.48), p = 0.718], and (5) pinch strength [MD (95% CI) = 0.72 (− 0.10–1.54), p = 0.083]. Conclusion This review provides low-quality evidence that gabapentin plus nocturnal splinting is not superior to splinting alone. More high-quality trials are needed to determine the role of this drug as an adjuvant in the management of CTS.


2020 ◽  
Vol 10 (02) ◽  
pp. 73-88
Author(s):  
Mohamed Farouk Agag ◽  
Moutaz M. Kamal Elsharkawy ◽  
Ahmed Khedewy Ahmed

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