Carpal Tunnel Syndrome. Part II: Effectiveness of Surgical Treatments—A Systematic Review

Huisstede, Bionka M. A.; Randsdorp, Manon S.; Coert, J. Henk; Glerum, Suzanne; Middelkoop, Marienke van; Koes, Bart W.

doi:10.1016/j.apmr.2010.03.023

Cited by 118 publications

(84 citation statements)

References 71 publications

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“…Recent systematic reviews have shown short-term effectiveness of oral and local steroids, surgery, ultrasound, electromagnetic field therapy, nocturnal splinting, and ergonomic keyboards (Huisstede et al, 2010a and2010b). Dammers et al (1999) showed that corticosteroid injections have better results than placebo injections in a randomized, double-blind, controlled trial.…”

Section: Introductionmentioning

confidence: 98%

The long-term follow-up of treatment with corticosteroid injections in patients with carpal tunnel syndrome. When are multiple injections indicated?

Berger

Vermeulen

Koelman

et al. 2012

J Hand Surg Eur Vol

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The objective of this prospective study was to investigate the long-term effect of one or more local corticosteroid injections in patients with carpal tunnel syndrome and whether a good response can be predicted. Follow-up visits took place at 3 weeks, 6 months, and 1 year after the first corticosteroid injection. Thirty of the 120 patients (25%) had a good outcome with a single injection, 11 additional patients (9%) needed a second injection, and five patients (4%) needed a third injection to reach a good outcome after 1 year. Of patients with an initial good treatment response, 28 (52%) had a good outcome after 1 year compared with 18 (27 %) who had an initially moderate or no response to treatment. One-third of patients with carpal tunnel syndrome had a long-term beneficial effect from corticosteroid injection, especially when they had a good initial response.

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Section: Introductionmentioning

confidence: 98%

The long-term follow-up of treatment with corticosteroid injections in patients with carpal tunnel syndrome. When are multiple injections indicated?

Berger

Vermeulen

Koelman

et al. 2012

J Hand Surg Eur Vol

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show abstract

“…However, presently, there is no evidence of any significant long-term advantages of less-invasive procedures than open release surgery. 47 When amyloid deposition occurs along flexor tendons, physicians could detect the pathognomonic "guitar string" sign; when the fingers are extended, the flexor tendons become prominent due to amyloid deposition in soft tissue of the palm 48 ( Figure 5). When the clinical picture worsens, DRA patients' fingers could have irreducible flexion contractures.…”

mentioning

confidence: 99%

Dialysis-related amyloidosis: challenges and solutions

Scarpioni¹,

Ricardi²,

Albertazzi³

et al. 2016

IJNRD

108

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Amyloidosis refers to the extracellular tissue deposition of fibrils composed of lowmolecular-weight subunits of a variety of proteins. These deposits may result in a wide range of clinical manifestations depending upon their type, location, and the amount of deposition. Dialysis-related amyloidosis is a serious complication of long-term dialysis therapy and is characterized by the deposition of amyloid fibrils, principally composed of b2 microglobulins (b2M), in the osteoarticular structures and viscera. Most of the b2M is eliminated through glomerular filtration and subsequent reabsorption and catabolism by the proximal tubules. As a consequence, the serum levels of b2M are inversely related to the glomerular filtration rate; therefore, in end-stage renal disease patients, b2M levels increase up to 60-fold. Serum levels of b2M are also elevated in several pathological conditions such as chronic inflammation, liver disease, and above all, in renal dysfunction. Retention of amyloidogenic protein has been attributed to several factors including type of dialysis membrane, prolonged uremic state and/or decreased diuresis, advanced glycation end products, elevated levels of cytokines and dialysate. Dialysis treatment per se has been considered to be an inflammatory stimulus, inducing cytokine production (such as interleukin-1, tumor necrosis factor-α, interleukin-6) and complement activation. The released cytokines are thought to stimulate the synthesis and release of b2M by the macrophages and/or augment the expression of human leukocyte antigens (class I), increasing b2M expression. Residual renal function is probably the best determinant of b2M levels. Therefore, it has to be maintained as long as possible. In this article, we will focus our attention on the etiology of dialysis-related amyloidosis, its prevention, therapy, and future solutions.

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“…Local steroid injection and surgical decompression have been compared in numerous studies. Based on the level of evidence for mild to moderate CTS, local steroid injection, while for moderate to severe CTS surgical decompression has been recommended (12,13,19).…”

mentioning

confidence: 99%

Comparison of short-term clinical and electrophysiological outcomes of local steroid injection and surgical decompression in the treatment of carpal tunnel syndrome running title: steroid injection and surgical decompression in carpal tunnel syndrome

Gürçay¹,

Karaahmet²,

Gurcan³

et al. 2015

Turkish Neurosurgery

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Carpal Tunnel Syndrome. Part II: Effectiveness of Surgical Treatments—A Systematic Review

Cited by 118 publications

References 71 publications

The long-term follow-up of treatment with corticosteroid injections in patients with carpal tunnel syndrome. When are multiple injections indicated?

The long-term follow-up of treatment with corticosteroid injections in patients with carpal tunnel syndrome. When are multiple injections indicated?

Dialysis-related amyloidosis: challenges and solutions

Comparison of short-term clinical and electrophysiological outcomes of local steroid injection and surgical decompression in the treatment of carpal tunnel syndrome running title: steroid injection and surgical decompression in carpal tunnel syndrome

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