Relationship Between the Duration and Severity of Symptoms and the Outcome of Carpal Tunnel Surgery

Abstract

There is no consensus regarding the prognostic value of preoperative symptom severity and duration for determining the anticipated results of carpal tunnel release. Some studies show a detrimental influence of symptom duration and severity on outcomes; others have found no effect. To study these contradictions, a database was created at 2 separate hand centers to explore the extent to which the duration and severity of symptoms before surgery are predictive of surgical outcome. At 2 hand centers 523 hands from the United States and United Kingdom completed surgery and follow-up evaluation. Symptoms, time of onset, duration, prior treatment, and medical history were recorded. Each patient had a physical examination and completed the Levine-Katz questionnaire. Symptom duration, corrected for gender, was not associated with Levine-Katz symptom severity, Levine-Katz functional status, or changes in these scores from the pretreatment to 6-month follow-up evaluations. Preoperative symptom duration does not affect the surgery outcome as determined by the Levine-Katz symptom severity or functional status scores. The more severe the symptoms as determined by patient self-assessment, the greater the amount of change in the Levine-Katz symptom severity and functional status scores, although at 6 months after surgery the scores were still higher than those of patients with milder cases.