Two-port Endoscopic Surgery for Carpal Tunnel Syndrome - A Prospective Cohort Study.

Abstract

Introduction:Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies affecting patients' life. Performing endoscopic carpal tunnel release is now a new technique that is being gradually applied in Vietnam. This paper seeks to investigate the effectiveness of Chow’s method for CTS treatment.Materials and methods:This is a prospective cohort study involving seventy-seven patients with CTS who underwent Chow’s endoscopic method at our hospital from March 2019 to January 2020. The Boston Carpal Tunnel Questionnaire and electromyography (EMG) were used primarily to evaluate surgical decompression pre-operatively, one week, three weeks, three months, and six months after surgery. We also recorded incision length, pain at the scar, the improvement of symptoms and thenar atrophy and return-to-work time after surgery.Results:A total of 85.7% of the patients were women. A moderate severity of EMG was seen in 64.9% of cases. Six-month post-operative functional status scale (FSS) (1.05±0.1) and symptom severity scale (SSS) (1.05±0.1) showed significant improvement when compared with preoperative FSS (2.8±0.5) and SSS (3.2±0.5). Post-operative EMG showed the distal sensory latency (DSL) and distal motor latency (DML) had returned to the norm in 88% and 89.3%, respectively. The average incision length was 12.1±1.2mm. Six months after surgery, numbness and hand pain had resolved in 97.4%, a painless scar was seen in 94.7%, but full recovery of thenar atrophy was only seen in 9.1%. Patients could get back to work after 10.2±2.4 days.Conclusion:Chow’s endoscopic carpal tunnel release is a safe and effective procedure for patients suffering from carpal tunnel syndrome that showed promising outcomes on clinical symptoms and functions on EMG with minimal pain and scarring, and early return to work.