Endoscopic decompression of middle nerve in patients with carpal tunnel syndrome

Authors

  • Vitaliy Tsymbaliuk Restorative Neurosurgery Department, Romodanov Neurosurgery Institute, Kiev, Ukraine https://orcid.org/0000-0001-7544-6603
  • Iurii Chyrka Department of Neurology and Neurosurgery, National Pirogov Memorial Medical University, Vinnitsa, Ukraine

DOI:

https://doi.org/10.25305/unj.45296

Keywords:

carpal tunnel syndrome, median nerve, endoscopic decompression

Abstract

Purpose. Results of endoscopic surgical treatment evaluation in patients with carpal tunnel syndrome.

Materials and methods. For median nerve decompression in the carpal tunnel endoscopic technique and K.G. Krishnan tools were selected. The detailed technique of endoscopic intervention using carpal approach is described. The results of 34 patient’s treatment with carpal tunnel syndrome (CTS) were analyzed.

Results. Patients’ state was evaluated before surgery, on the 7 and 30 days after surgery. Regression of neuropathic pain, according to the questionnaire BCTQ, was observed in all operated patients. Functional outcome worsened on the 7day after surgery, but in a month later patients reported significant improvement in hand function that corresponds to changes in control electroneuromyography and ultrasound scanning of the middle nerve. In one case after surgery hypoesthesia regression was not achieved.

Conclusions. Endoscopic technique is a method of choice in patients with CTS. Due to miniinvasive approach and sufficient carpal tunnel visualization, it can be successfully used in routine neurosurgical practice. Treatment results indicate efficacy of endoscopic method and fast rehabilitation of the patients.

References

Chow J. Endoscopic release of the carpal ligament: A new technique for carpal tunnel syndrome. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 1989;5(1):19-24. CrossRef

Meirelles L, Santos J, Santos L, Branco M, Faloppa F, Leite V, Fernandes C. Avaliação do questionário de Boston aplicado no pós-operatório tardio da síndrome do tunel do carpo operados pela técnica de retinaculótomo de paine por via palmar. Acta Ortopédica Brasileira. 2006;14(3). CrossRef

Martin KD, Dützmann S, Sobottka SB, Rambow S, Mellerowicz HA, Pinzer T, Schackert G, Krishnan KG. Retractor-Endoscopic Nerve Decompression in Carpal and Cubital Tunnel Syndromes: Outcomes in a Small Series. World Neurosurgery. 2014;82(1-2):e361-e370. CrossRef

Iannotti J, Parker R. Musculoskeletal System. Part II. Spine And Lower Limb. In: Netter F, ed. The Ciba Collection Of Medical Illustrations. New Jersey: CIBA-Geigy; 1987.

Cobb T, Dalley B, Posteraro R, Lewis R. Anatomy of the flexor retinaculum. The Journal of Hand Surgery. 1993;18(1):91-99. CrossRef

Mirza M, King E Jr. Newer techniques of carpal tunnel release. Orthop Clin North Am. 1996; 27(2):355–371. PubMed

Kretschmer T, Antoniadis G, Richter H, König R. Avoiding Iatrogenic Nerve Injury in Endoscopic Carpal Tunnel Release. Neurosurgery Clinics of North America. 2009;20(1):65-71. CrossRef

Agee J, McCarroll H, Tortosa R, Berry D, Szabo R, Peimer C. Endoscopic release of the carpal tunnel: A randomized prospective multicenter study. The Journal of Hand Surgery. 1992;17(6):987-995. CrossRef

Published

2015-06-27

How to Cite

Tsymbaliuk, V., & Chyrka, I. (2015). Endoscopic decompression of middle nerve in patients with carpal tunnel syndrome. Ukrainian Neurosurgical Journal, (2), 54–58. https://doi.org/10.25305/unj.45296

Issue

Section

Original articles