Clinical predictors of surgical outcomes of severe carpal tunnel syndrome patients: utility of palmar stimulation in a nerve conduction study

BMC Musculoskeletal Disorders

Tohru Terao¹  Keiichiro Ohara¹  Shotaro Michishita¹  Yuichi Sasaki¹  Emiko Saito¹  Naoki Kato²  Yuichi Murayama²  Satoshi Tani² 

[1] Department of Neurosurgery, Atsugi City Hospital, 1-16-36 Mizuhiki, 243-8588, Atsugi-shi, Kanagawa, Japan;Department of Neurosurgery, The Jikei University Hospital, Tokyo, Japan;

关键词: Carpal tunnel syndrome;    Nerve conduction study;    Bland’s classification;    Axonal degeneration;   

DOI  :  10.1186/s12891-020-03750-z

来源: Springer

【 摘 要 】

BackgroundCarpal tunnel syndrome is a common peripheral nerve compression disorder. However, there is no established opinion regarding the predictors of symptom improvement after surgery. This study aimed to identify the predictors of surgical outcomes of severe carpal tunnel syndrome patients.MethodsIn the patients who underwent a carpal tunnel syndrome surgery, we selected the patients who had a preoperative Bland’s classification of grade 5 or 6, and assessed for the changes in Bland’s classification grade before and after surgery. Those who showed improvement from preoperative grades 5–6 to postoperative grades 1–4 comprised the improvement group. In contrast, those who did not show improvement and had postoperative grades 5 or 6 comprised the non-improvement group. In a nerve conduction study, amplitudes of the compound muscle action potential and sensory nerve action potential of the palms were assessed between the improvement and non-improvement groups.ResultsAmong the 60 hands of 46 patients who had a preoperative Bland’s classification of grade 5 or 6, 49 hands of 37 patients comprised the improvement group, and 11 hands of 9 patients comprised the non-improvement group. The amplitudes of the compound muscle action potential and sensory nerve action potential of the palms before surgery were significantly higher in the improvement group. The degree of improvement in Bland’s classification grade was correlated with the degree of clinical symptom improvement.ConclusionsAmplitudes of compound muscle action potential and sensory nerve action potential before surgery induced by palmar stimulation can predict improvements in nerve conduction study scores and clinical findings after surgical treatment.

【 授权许可】

CC BY