Faculty Opinions recommendation of 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.

Background: The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy). Methods: Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan. Results: From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months. Conclusions: Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.

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Short-term Effects of Neurodynamic Techniques for Treating Carpal Tunnel Syndrome: A Systematic Review With Meta-analysis

Journal of Orthopaedic and Sports Physical Therapy ◽

10.2519/jospt.2021.10533 ◽

2021 ◽

pp. 1-67

Author(s):

Sergio Núñez de Arenas-Arroyo ◽

Iván Cavero-Redondo ◽

Ana Torres-Costoso ◽

Sara Reina-Gutiérrez ◽

Celia Álvarez-Bueno ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Meta Analysis ◽

Short Term ◽

Tunnel Syndrome ◽

Short Term Effects

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Systematic review and meta-analysis of surgical options for recurrent or persistent carpal tunnel syndrome: simple decompression versus coverage of the median nerve

Journal of Hand Surgery (European Volume) ◽

10.1177/17531934211001715 ◽

2021 ◽

pp. 175319342110017

Author(s):

Saskia F. de Roo ◽

Philippe N. Sprangers ◽

Erik T. Walbeehm ◽

Brigitte van der Heijden

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Meta Analysis ◽

Surgical Techniques ◽

Open Release ◽

Flap Coverage ◽

Tunnel Syndrome

We performed a systematic review on the success of different surgical techniques for the management of recurrent and persistent carpal tunnel syndrome. Twenty studies met the inclusion criteria and were grouped by the type of revision carpal tunnel release, which were simple open release, open release with flap coverage or open release with implant coverage. Meta-analysis showed no difference, and pooled success proportions were 0.89, 0.89 and 0.85 for simple open carpal tunnel release, additional flap coverage and implant groups, respectively. No added value for coverage of the nerve was seen. Our review indicates that simple carpal tunnel release without additional coverage of the median nerve seems preferable as it is less invasive and without additional donor site morbidity. We found that the included studies were of low quality with moderate risk of bias and did not differentiate between persistent and recurrent carpal tunnel syndrome.

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Gabapentin as an adjuvant therapy to splinting in carpal tunnel syndrome (CTS): a systematic review and meta-analysis of randomized controlled trials

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00237-5 ◽

2020 ◽

Vol 56 (1) ◽

Author(s):

Ahmed M. Ahmed ◽

Osama G. Hassan ◽

Ahmed A. Khalifa

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Pinch Strength ◽

Symptom Severity Scale ◽

Significant Difference ◽

Tunnel Syndrome

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.

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Utility of Ultrasound Elastography in Evaluation of Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2019.07.409 ◽

2019 ◽

Vol 45 (11) ◽

pp. 2855-2865 ◽

Cited By ~ 14

Author(s):

Chih-Peng Lin ◽

Ing-Jeng Chen ◽

Ke-Vin Chang ◽

Wei-Ting Wu ◽

Levent Özçakar

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Meta Analysis ◽

Ultrasound Elastography ◽

Tunnel Syndrome

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Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

10.21203/rs.3.rs-125732/v1 ◽

2020 ◽

Author(s):

Fu-An Yang ◽

Ya-Chu Shih ◽

Jia-Pei Hong ◽

Chin-Wen Wu ◽

Chun-De Liao ◽

...

Keyword(s):

Systematic Review ◽

Carpal Tunnel Syndrome ◽

Randomized Controlled Trials ◽

Carpal Tunnel ◽

Corticosteroid Injection ◽

Meta Analysis ◽

Controlled Trials ◽

Ultrasound Guided ◽

Randomized Controlled ◽

Tunnel Syndrome

Abstract Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. Randomized controlled trials (RCTs) were identified, and data collection was completed on 7 October 7, 2020. Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD = −0.49, 95% CI (−0.74, −0.25), P < 0.0001], Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD = −0.24, 95% CI (−0.42, −0.06), P = 0.01], distal motor latency [SMD = −0.36, 95% CI (−0.70, −0.02), P = 0.04], and compound muscle action potential [SMD = 0.38, 95% CI (0.16, 0.61), P = 0.0008] . Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

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