One Year Follow‐Up In Diabetic Patients After Surgical Treatment Of Carpal Tunnel Syndrome

Abstract

The aim of the study was to evaluate clinical and neurophysiological changes in diabetic patients who had the surgery of carpal tunnel syndrome (CTS). The group consisted of 61 diabetic patients with the clinical and neurophysiological signs of CTS, with mean age 50.3 (± 27.3) and diabetes duration 13.5 years (± 8.9). The response to treatment was evaluated using visual analogue scale (VAS) for pain and for paresthesias prior to surgery, as well as 3 and 12 months after. At the same time we compared the median motor distal latency, amplitude of motor nerve action potentials, sensory conduction velocity and amplitude of sensory nerve action potentials in distal segment of median nerve as well as vibration perception threshold. The improvement was found for pain (baseline VAS 4.5 cm vs. follow‐up VAS 1.5 cm; Wilcoxon p = 0.00365) and for paresthesias (baseline VAS 5.4 cm vs. follow‐up VAS 0.8 cm; Wilcoxon p = 0.00000) after 3 months. Subjective pain and paresthesias assessment remained at the improved level after 12 months of follow‐up. Neurophysiological parameters measured were shown to improve after 3 and 12 months of follow‐up period: median motor distal latency (baseline 5.9 ms/6 cm, 3 months 4.8 ms/6 cm, 12 months 4.1 ms/6 cm; ANOVA p < 0.00000), amplitude of median motor action potential (baseline 4.8 mV, 3 months 5.6 mV, 12 months 6.6 mV., ANOVA p < 0.01040), median sensory conduction velocity in distal segment (baseline 37.9 m/s, 3 months 43.0 m/s, 12 months 47.3 m/s, ANOVA p < 0.00464), vibration perception threshold (baseline 9.8 V, 3 months 7.6 V, 12 months 6.8 V; ANOVA p < 0.00006). Concerning our results, the clinical and neurophysiological parameters supported surgery as the effective treatment for CTS in diabetics.