Advanced Biomedical Research

Changes in electrophysiological parameters after open carpal tunnel release

Authors

1 Department of Orthopedics, Medical University of Isfahan Kashani Hospital, Isfahan, Iran

2 Physical Medicine and Rehabilitation at Isfahan University of Medical and Health Sciences, Isfahan, Iran

3 General Physician Medical University of Isfahan, Isfahan, Iran

Abstract

Background: Carpal tunnel syndrome (CTS) is the most frequent compressive mononeuropathy, affecting mostly females. Few studies have been performed to assess the electrophysiological parameters before and after carpal tunnel release. The purpose of our study was to evaluate these changes postoperatively and in the course of a 9-month period after operation in comparison with the preoperative values.
Materials and Methods: A case-series study was carried out and included 17 cases of moderate or severe electrophysiologically confirmed CTS, who underwent open carpal tunnel release (CTR) from December 2010 to May 2011. Severity grade was assigned following American Association of the Electrodiagnostic Medicine criteria of CTS. Distal motor and sensory latencies and sensory nerve conduction velocity of the median nerve across the carpal tunnel were evaluated and compared before, at 6, and 9 months after surgery.
Results: From the 17 evaluated hand with moderate, moderate to severe and severe CTS, severity improvement was reported in 82.3% 6 months and in 88.2% 9 months after surgery, but only 47% had satisfied or completely satisfied opinion about the results. Others, though still complaining of serious symptoms, had improved or normal NCS.
Discussion: Electrophysiological investigations outlined severity improvement after CTR. In the current study, the electrophysiological studies were not meaningful in determining outcome.

Keywords

1. Scott KR, Kothari MJ. Clinical manifestations and diagnosis of carpal tunnel syndrome. 2011. Available at: http://uptodate.com/contents/clinical-manifestations-and-diagnosis-of-carpal-tunnel-syndrome?[Last accessed on 2010 May].  Back to cited text no. 1
    
2. Wright PE. Carpal tunnel, ulnar tunnel, and stenosing tenosynovitis. In: Canale ST, Beaty JH. Campbell's operative orthopaedics. 11th ed. Philadelphia: Mosby Elsevier; 2008. p. 4285-98.  Back to cited text no. 2
    
3. Tay LB, Urkude R, Verma KK. Clinical profile, electrodiagnosis and outcome in patients with carpal tunnel syndrome: A Singapore perspective. Singapore Med J 2006;47:1049-52.  Back to cited text no. 3
    
4. Gong H, Oh J, Bin S, Kim W, Chung M, Baek G. Clinical features influencing the patient- based outcome after carpal tunnel release. J Hand Surg 2008;33A:1512-7.  Back to cited text no. 4
    
5. Vogt T, Scholz J. Clinical outcome and predictive value of electrodiagnostics in endoscopic carpal tunnel surgery. Neurosurg Rev 2002;25:218-21.  Back to cited text no. 5
[PUBMED]    
6. Mackinnon SE, Novak CB. Compression neuropathies. In: Green DP, Wolfe SW. Green's operative hand surgery. 6th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2011. p. 984-90.  Back to cited text no. 6
    
7. Dhong ES, Han SK, Lee BI, Kim WK. Correlation of electrodiagnostic findings with subjective symptoms in carpal tunnel syndrome. Ann Plast Surg 2000;45:127-31.  Back to cited text no. 7
    
8. Schrijiver HM, Gerritsen AA, Strijers RL, Uitdehaag BM, Scholten RJ, de Vet HC, et al. Correlating nerve conduction studies and clinical outcome measures on carpal tunnel syndrome: Lessons from a randomized controlled trial. J Clin Neurophysiol 2005;22:216-21.  Back to cited text no. 8
[PUBMED]    
9. Choi SJ, Ahn DS. Correlation of clinical history and electrodiagnostic abnormalities with outcome after surgery for carpal tunnel syndrome. Plast Reconstr Surg 1998;102:2374-80.  Back to cited text no. 9
    
10. Jackson DA, Clifford JC. Electrodiagnosis of mild carpal tunnel syndrome. Arch Phys Med Rehabil 1989;70:199-204.  Back to cited text no. 10
[PUBMED]    
11. Stevens JC. AAEM minimonograph #26: The electrodiagnosis of carpal tunnel syndrome. Muscle Nerve 1997;20:1477-86.  Back to cited text no. 11
[PUBMED]    
12. Seror P. Nerve conduction studies after treatment for carpal tunnel syndrome. J Hand Surg 1992;17B:641-5.  Back to cited text no. 12
[PUBMED]    
13. El-Hajj T, Tohme R, Sawaya R. Changes in electrophysiological parameters after surgery for the carpal tunnel syndrome. J Clin Neurophysiol 2010;27:224-6.  Back to cited text no. 13
    
14. Ginanneschi F, Milani P, Reale F, Rossi A. Short-term electrophysiological conduction change in median nerve fibers after carpal tunnel release. Clin Neurol Neurosurg 2008;110:1025-30.  Back to cited text no. 14
[PUBMED]    
15. Mondelli M, Reale F, Sicurelli F, Padua L. Relationship between the self-administered Boston questionnaire and electrophysiological findings in follow-up of surgically-treated carpal tunnel syndrome. J Hand Surg Br 2000;25:128-34.  Back to cited text no. 15
[PUBMED]    
16. Prick JJ, Blaauw G, Vredeveld JW, Oosterloo SJ. Results of carpal tunnel release. Eur J Neurol 2003;10:733-6.  Back to cited text no. 16
[PUBMED]    
17. Shurr DG, Blair WF, Bassett G. Electromyographic changes after carpal tunnel release. J Hand Surg Am 1986;11:876-80.  Back to cited text no. 17
[PUBMED]    
18. Naidu SH, Fisher J, Heistand M, Kothari MJ. Median nerve function in patients undergoing carpal tunnel release: Pre- and post-op nerve conductions. Electromyogr Clin Neurophysiol 2003;43:393-7.  Back to cited text no. 18
[PUBMED]    
 
Advanced Biomedical Research
Volume 2012, August
August 2012
Pages 1-6