Abstract
BackgroundCarpal tunnel syndrome is a common peripheral nerve compression disorder. However, there is no established opinion regarding the predictors of symptom improvement after surgery. This study aimed to identify the predictors of surgical outcomes of severe carpal tunnel syndrome patients.MethodsIn the patients who underwent a carpal tunnel syndrome surgery, we selected the patients who had a preoperative Bland’s classification of grade 5 or 6, and assessed for the changes in Bland’s classification grade before and after surgery. Those who showed improvement from preoperative grades 5–6 to postoperative grades 1–4 comprised the improvement group. In contrast, those who did not show improvement and had postoperative grades 5 or 6 comprised the non-improvement group. In a nerve conduction study, amplitudes of the compound muscle action potential and sensory nerve action potential of the palms were assessed between the improvement and non-improvement groups.ResultsAmong the 60 hands of 46 patients who had a preoperative Bland’s classification of grade 5 or 6, 49 hands of 37 patients comprised the improvement group, and 11 hands of 9 patients comprised the non-improvement group. The amplitudes of the compound muscle action potential and sensory nerve action potential of the palms before surgery were significantly higher in the improvement group. The degree of improvement in Bland’s classification grade was correlated with the degree of clinical symptom improvement.ConclusionsAmplitudes of compound muscle action potential and sensory nerve action potential before surgery induced by palmar stimulation can predict improvements in nerve conduction study scores and clinical findings after surgical treatment.
Highlights
Carpal tunnel syndrome is a common peripheral nerve compression disorder
By comparing the amplitudes of the compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) in the wrist and palm, we evaluated the degrees of conduction block and axonal degeneration at the pre and postoperative stages
Among the 60 hands of the 46 patients with a preoperative Bland’s classification of grade 5 or 6, 49 hands of 37 patients were included in the improvement group (Table 1)
Summary
Carpal tunnel syndrome is a common peripheral nerve compression disorder. there is no established opinion regarding the predictors of symptom improvement after surgery. This study aimed to identify the predictors of surgical outcomes of severe carpal tunnel syndrome patients. Carpal tunnel syndrome (CTS) is the most common type of peripheral nerve compression disorder. The previous studies have shown that the clinical outcomes after surgery depend on multiple factors; there is no established opinion regarding predictors of symptom improvement after surgery. By comparing the amplitudes of the CMAP and SNAP in the wrist and palm, we evaluated the degrees of conduction block and axonal degeneration at the pre and postoperative stages.
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