Exploring Relationships Between Ultrasound-Measured Pre-Operative Median Nerve Echointensity and Successful Carpal Tunnel Release-A Retrospective Review (P14-8.002)

Abstract

<h3>Objective:</h3> The purpose of this study is to explore the association between preoperative median nerve echointensity and outcomes of carpal tunnel release (CTR). <h3>Background:</h3> Published success rates of CTR vary from 27–100%. With the advancement of neuromuscular ultrasound (NMUS), nerve echointensity has gained increased attention as an indicator of intraneural edema. <h3>Design/Methods:</h3> We performed a retrospective review of the electronic medical record to identify patients who underwent sonographic evaluation of the median nerve and CTR surgery at Duke University within 4 months. Those with concurrent polyneuropathy were excluded. Surgical outcomes were determined by 2 independent reviewers based upon chart review of the postoperative visit 4–6 weeks after surgery. A 3^rd reviewer assessed the outcome in the event of disagreement. Complete resolution was defined in the absence of paresthesia, pain, and functional limitation pertinent to carpal tunnel syndrome. <h3>Results:</h3> A total of 56 nerves from 50 patients were identified. Of these patients, 33 (66%) were women and the mean age was 57.2 years (SD = 14.2). Complete resolution occurred in 39 (69.6%) surgeries. Multivariable logistic regression model, adjusted for age and gender, showed no association between median nerve echointensity and complete versus partial resolution (OR=1.01; 95% CI = 0.99–1.03). Inter-rater reliability was excellent in both outcome assessment (% agreement = 96.4, kappa =0.92) and measurement of echointensity (interclass correlation: 0.914). <h3>Conclusions:</h3> Our study did not demonstrate differences in preoperative median nerve echointensity between patients with complete and partial resolution of symptoms following CTR surgery. However, the measurement of echointensity and outcomes assessment had excellent interrater reliability. A multi-center prospective study should be pursued for better understandings of the relationship between NUS parameters and the outcomes of CTR surgery. <b>Disclosure:</b> Dr. Harada has nothing to disclose. Dr. Wannarong has nothing to disclose. Dr. Neely has received personal compensation for serving as an employee of Duke University . An immediate family member of Prof. Williams has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for SQZ Biotech. An immediate family member of Prof. Williams has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Viracta Therapeutics. Prof. Williams has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Origin Editorial. The institution of Prof. Williams has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for PCORI. The institution of Prof. Williams has received research support from PCORI. The institution of Prof. Williams has received research support from NIH. Prof. Williams has received publishing royalties from a publication relating to health care. Dr. Pidgeon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for QPix. Dr. Pidgeon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tissium. The institution of Dr. Pidgeon has received research support from Acumed. An immediate family member of Dr. Hobson-Webb has received personal compensation for serving as an employee of G1 Therapeutics. Dr. Hobson-Webb has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley Publishing. The institution of Dr. Hobson-Webb has received research support from Sanofi Genzyme.