A study the various clinical and electrophysiological parameters of severity of carpal tunnel syndrome, their correlation with post-operative recovery

Abstract

Objective:We aimed to study the various clinical and electrophysiological parameters of severity of carpal tunnel syndrome (CTS) and to see if the severity of CTS affects recovery after surgery.Patients and Methods:A prospective study of 35 patients suffering from CTS. Clinical severity was assessed using visual analogue scale and standard questionnaires such as Levine and Disabilities of Arm, Shoulder and Hand questionnaires. All the patients underwent electrophysiological evaluation to assess electrophysiological severity of CTS. According to modified Padua classification, they were classified into three groups, namely, minimal to mild, moderate and severe to extreme. All patients underwent Carpal tunnel release in our unit. The clinical assessment was repeated 3 months post-operatively.Results:Out of 33 patients, majority (65.7%) of the patients were suffering from moderately severe CTS. The clinical provocative tests were positive in majority of patients. Clinically and statistically significant (P < 0.001) improvement was seen in all clinical severity scores. However, it did not show any statistical correlation with electrophysiological severity of the disease when compared among the groups. There was no association of age, gender of the patient, body mass index, hand dominance, affected side of the patient, results of provocative tests and the presence or absence of thenar muscle atrophy when compared among the three severity groups (P > 0.05).Conclusions:Although pre-operative clinical scores of severity and electrophysiology have a diagnostic role in CTS, they do not correlate with post-operative recovery and in turn fail to predict the extent of post-operative recovery before surgery.

Comparative study between pre- and post- operative clinical and electrophysiological parameters in determining the recovery of carpal tunnel syndrome

“…According to Nehete et al, the difference between pre operative and post-operative scores is a good indicator of post-operative recovery, but it does not show any correlation when compared with electrophysiological severity. 10 The study reconfirms the diagnostic role of NCV in CTS, but the electrophysiological severity does not always match the clinical severity. 10 Our study showed that there is no definitive relation between electrophysiological severity and clinical severity scores.…”

“…10 The study reconfirms the diagnostic role of NCV in CTS, but the electrophysiological severity does not always match the clinical severity. 10 Our study showed that there is no definitive relation between electrophysiological severity and clinical severity scores. In our study, we found the difference between preoperative and post-operative scores is a good indicator of post-operative recovery, but it does show a weak correlation when compared with electrophysiological severity.…”

“…Self-administered questionnaires have been proposed for CTS to assess the severity of the condition from the patient's point of view. 10 Such questionnaires can be used to check whether a certain therapy relieves symptoms and improves the functional status. We report a comparative study between the Boston questionnaire (BQ) and median nerve conduction study parameters in patients with CTS treated by division of the flexor retinaculum through a short incision at the palm.…”

Electrophysiological Grading to Assess the Severity of Carpal Tunnel Syndrome in Symptomatic Diabetic Patients

“…This result is in favour of some other study results 14 . whereas some studies showed Carpal tunnel syndrome may be present in up to 42% in workers in certain occupations (e.g., poultry processing) and has annual incidence of 193 per 100,000 in all women 15 . Other high -risk occupations are computer professionals 16 , assembly line workers, concert pianists and construction workers with vibrating power tools 17 .…”

Reawakening Neuritis of the Median Nerve after Carpal Tunnel Release: Defining and Predicting Patients at Risk

“…Although clinical severity scores have a diagnostic role in carpal tunnel syndrome, they do not correlate with recovery following carpal tunnel release. 3 Favorable results and high patient satisfaction have been reported for patients with severe disease undergoing carpal tunnel release. 4 We have recognized a subset of patients with severe disease who do not follow the typical, uneventful recovery pathway postoperatively.…”