Abstract
Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. A search of the PubMed, Cochrane Library, and Embase databases was performed from the date of their inception to October 7, 2020 to identify randomized controlled trials (RCTs). Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results than landmark-guided injection for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD = − 0.43, 95% CI (− 0.68, − 0.19), P = 0.0005] and Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD = − 0.50, 95% CI (− 0.84, − 0.15), P = 0.005]. Ultrasound-guided corticosteroid injection is recommended for patients with CTS.
Highlights
Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel
Diagnosed through a nerve conduction study; (3) patients with no previous surgical treatment; (4) primary study aim to compare the clinical effectiveness of ultrasound- and landmark-guided corticosteroid injection in patients with CTS; and (5) outcome measurements including the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and electrodiagnostic findings
199 references that were noncompliant with the inclusion criteria were excluded after their titles and abstracts were screened
Summary
Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel[1]. A systematic review and meta-analysis conducted by Arash et al indicated that ultrasound-guided injection is more effective than landmark-guided injection in terms of symptom severity but not in terms of functional status and electrodiagnostic outcomes[20]. Their meta-analysis featured only three randomized controlled trials (RCTs), and numerous additional studies have recently been conducted. The effects of ultrasound- and landmark-guided corticosteroid injection on symptom severity, functional status, and electrodiagnostic outcomes in patients with CTS
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