The Correlation of Carpal Tunnel Pressure with Clinical Outcomes following Ultrasonographically-Guided Percutaneous Carpal Tunnel Release.

Abstract

Background: To evaluate the correlation between carpal tunnel pressure (CTP) and the clinical presentations, and to explore the possible predictors for the postoperative recovery pattern in patients with carpal tunnel syndrome (CTS). Materials and Methods: Consecutive patients with idiopathic CTS following percutaneous ultrasound-guided carpal tunnel release (UCTR) were enrolled. CTP was measured preoperatively and immediately after operation. The Boston Carpal Tunnel Questionnaire (BCTQ) and the cross-sectional area (CSA) of median nerve were recorded preoperatively and at 1, 3, and 12 months postoperatively. Results: 37 patients (37 hands; 8 men and 29 females; median age, 59.0 years) were enrolled. CTP significantly decreased immediately from 40.0 (28.0–58.0) to 13.0 (8.0–20.0) mmHg after UCTR. BCTQ scores significantly improved at 1 month postoperatively, and the improvement trend persisted until 12 months postoperatively (p < 0.001). Preoperative CTP was positively correlated with preoperative CSA and preoperative BCTQ scores (p < 0.05, all). Using group-based trajectory modeling, all patients were categorized into the “gradual recovery” or “fast recovery” group. Higher preoperative CTP was significantly associated with a faster recovery pattern (odds ratio: 1.32). Conclusions: Preoperative CTP was well correlated with the clinical presentations and might be a useful predictor for the postoperative clinical recovery pattern.