Percutaneous full endoscopic carpal tunnel release using a 5.9 mm endoscope

Abstract

Objective To apply 5.9 mm whole cervical spine endoscopic system in the minimally invasive carpal tunnel release and evaluate its clinical effects, indications and safety. Methods A total of 11 patients with 14 sides of carpal tunnel syndrome were included in this study. There were 3 males and 8 females, with ages ranging from 36 to 56 years, with an average of 49 years. The right side was involved in 5 cases, left side in 3 cases and bilateral in 3 cases. Using the 5.9 mm endoscope cervical spine minimally invasive surgery system and bipolar radiofrequency, we accomplished percutaneous carpal tunnel release under local anesthesia. Three months after the surgery, Boston Carpal Tunnel Questionnaire (BCTQ), SF-36 and Disability of Arm, Shoulder and Hand (DASH) scores were used to evaluate the results. Results Pain symptoms disappeared entirely in all 11 patients. The nocturnal pain and numbness in 9 patients completely resolved. However, thenar atrophy persisted. The average postoperative DASH score was 13. The average BCTQ symptom severity score was 1.5, while the function grade was 1.5. Postoperative SF-36 scored 40 for the physical part and 57 for the mental part. Nine patients were satisfied with the outcomes, whereas two had a neutral response (neither satisfied nor dissatisfied). There were no postoperative infection, recurrence or neurovascular injuries. Conclusion Percutaneous 5.9 mm full-endoscope technology has advantages such as a smaller incision, a tourniquet-free technique, using local anesthesia, shorter operation time and faster postoperative recovery. These advantages warrant the development of a full endoscopic system dedicated to carpal tunnel release so the minimally invasive treatment of carpal tunnel syndrome will be safer and more effective. Key words: Carpal tunnel syndrome; Endoscopes; Surgical procedures,minimally invasive