J Korean Neurosurg Soc.  2014 Nov;56(5):390-394. 10.3340/jkns.2014.56.5.390.

Delayed Improvement after Endoscopic Carpal Tunnel Release

• Kim DH
• Cho BM
• Oh SM
• Park DS
• Park SH

• KMID: 2018096
• DOI: http://doi.org/10.3340/jkns.2014.56.5.390

Abstract

OBJECTIVE
In most patients with carpal tunnel syndrome (CTS), pain and/or paresthesia disappeared or decreased in a month after endoscopic carpal tunnel release (ECTR). However, subpopulation of patients showed delayed improvement following ECTR. We analyzed the delayed improvement hands to investigate the characteristics of those patients and to determine the predictable factors of delayed improvement.
METHODS
Single-portal ECTRs were performed in 1194 hands of 793 CTS patients from 2002 to 2011. Five-hundred seventy hands with minimal 1-year postoperative follow-up were included. We divided the 545 satisfied hands into early (group A) and delayed (group B) groups according to improvement period of 1 month. Demographic data, clinical severity and electrodiagnostic abnormality were compared between groups.
RESULTS
Group A included 510 hands and group B included 35 hands. In group B, 11 hands improved in 2 months, 15 hands in 3 months and 9 hands in 6 months, respectively. In group A/B, according to clinical severity, 60/1 hands were graded to I, 345/24 hands to II, 105/10 hands to III. In group A/B, based on electrodiagnostic abnormality, 57/3 hands were classified to mild, 221/11 hands to moderate and 222/21 hands to severe group. Statistical analysis between groups did not reach significance but electrodiagnostic or clinical severity had a tendency to affect the delayed response.
CONCLUSION
It is difficult to predict the factors contributing to postoperatively-delayed response in subpopulation of CTS patients. However, we recommend that postoperative observation for at least 6 months is necessary in patients without symptomatic improvement.

Keyword

Carpal tunnel syndrome; Endoscopy; Surgical decompression; Delayed improvement

MeSH Terms

Carpal Tunnel Syndrome
Decompression, Surgical
Endoscopy
Follow-Up Studies
Hand
Humans
Paresthesia

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