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

Gürçay, Ahmet Gürhan; Karaahmet, Özgür Zeliha; Gurcan, Oktay; Kazanci, Atilla; Karslı, Pınar Bora; Umay, Ebru; Acer, Sevtap; Ünlü, Ece

doi:10.5137/1019-5149.jtn.15936-15.0

Cited by 5 publications

(16 citation statements)

References 18 publications

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“…In the treatment of severe CTS, steroid injection and surgical decompression achieved favorable improvements in clinical and electrophysiological parameters within the short term without superiority of one treatment over the other (6). Therefore, in patients for whom surgical decompression cannot be applied, local steroid injections can be recommended as a less invasive and a promising treatment alternative.…”

Section: Variablesmentioning

confidence: 99%

“…According to the Cochrane database, local steroid injection for CTS provides greater clinical improvement in symptoms 1 month after injection compared with placebos (4,5). In our previous study, we found that local steroid injection and surgical decompression achieved favorable improvements in clinical and electrophysiological parameters within the short term without superiority of one treatment over other (6). Therefore, in patients for whom surgical decompression cannot be applied, a local steroid injection can be recommended as a less invasive and promising treatment alternative.…”

Section: Introductionmentioning

confidence: 99%

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Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

Karaahmet¹,

Gürçay²,

Kara³

et al. 2017

Turk J Med Sci

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Background/aim: This study aimed to compare the effectiveness of ultrasound (US)-guided injection versus blind injection of corticosteroids in the treatment of carpal tunnel syndrome (CTS). Materials and methods:This prospective, randomized clinical trial included patients with severe CTS based on clinical and electrophysiological criteria. The patients were evaluated for clinical and electrophysiological parameters at baseline and 4 weeks after treatment. Symptom severity and hand function were assessed by the Boston questionnaire. The patients underwent blind injection or US-guided injection.Results: When compared with baseline, both groups showed significant improvement in Boston questionnaire scores and all electrophysiological parameters. Significant differences were observed between the groups for clinical parameters (Boston Symptom Severity Scale: P = 0.007; Functional Status Scale: P < 0.001) in favor of the US-guided group. Conclusion:This study demonstrated that both US-guided and blind injections were effective in reducing symptoms and improving hand function. US-guided injections may yield more effective clinical results in the short-term than blind injections in the treatment of patients with severe CTS.

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Section: Variablesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

Karaahmet¹,

Gürçay²,

Kara³

et al. 2017

Turk J Med Sci

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“…Gurcay et al investigated the effectiveness of LCI and surgery in the treatment of patients with severe CTS. They reported that LCI and surgical decompression achieved significant clinical and electrophysiological improvements within a three-month period without superiority of one treatment over other 36 . The authors recommended that LCI could be applied as a less-invasive treatment alternative in patients with severe CTS.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Ertem

Şirin

Yılmaz

2019

Arq. Neuro-Psiquiatr.

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Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. Objective: The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Methods: Electrophysiological parameters were evaluated before and three months after LCI. Moreover, the Numeric Rating Scale (NRS), the Boston Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were administered before and after the injection. A mixture of 1 mL (40 mg) of methylprednisolone and 1 mL of 0.5% bupivacaine were injected blindly on the volar side of the forearm between the tendons of the radial carpal flexor muscle and long palmar muscle. Results: A total of 25 patients (45 hands) were enrolled in the study. Twenty women and five men with a mean age of 49.28 ± 11.37 years were included. A statistically significant difference was noted for improvement of sensory conduction velocities, sensory peak latency, and motor distal latency (p = 0.001) after LCI. A significant difference was recorded between pre- and post-injection for NRS, SSS and FSS scores (p = 0.000). Conclusion: Local corticosteroid injection for CTS provides a short-term improvement in neurophysiological and clinical outcomes such as pain intensity, symptom severity and functional ability.

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“…A clinical trial by Gurcay Ag and his colleagues shows the equivalent effect of steroid injection and surgical decompression in the improvement of clinical and electrophysiological parameters in a short-term period in patients with severe CTS. They indicated that local steroid injection is a viable option in patients for whom surgical decompression is contraindicated or undesirable [13].…”

Section: Hui Et Al Demonstrated That Open Carpal Tunnel Re-mentioning

confidence: 99%

Revisiting the Urge to Operate: One-year Neurophysiological Follow-up in Severe CTS

et al. 2020

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Background and Aim: Several approaches have been proposed for the treatment of Carpal Tunnel Syndrome (CTS) based on its severity. The aim of this study is to determine the optimal management for severe CTS. Methods and Materials/Patients: This cross-sectional study was conducted for 22 months from August 2017 to June 2019 in a referral rehabilitation clinic in southern Iran. A total of 117 hands diagnosed with severe CTS were included in 78 patients according to Electrodiagnostic Study (EDX) reports (considering Sensory Proximal Latency (SPL) >3.6 msec, Sensory Distal Latency (SDL) >5.3 msec, Sensory Nerve Conduction Velocity (SNCV) <30 m/sec, Distal Motor Latency (DML) >6.5 msec as being severe) who refused to undergo surgery. Boston questionnaire was filled out and conventional EDX was carried out at the first and the 1-year follow-up visits. Results: In patients with a detectable Sensory Nerve Action Potential (SNAP), motor amplitude (P<0.002) and latency (P<0.01), SPL (P<0.003) and SNCV (P<0.006), and Boston parameters improved significantly in the one-year follow-up visit compared with the results at the first visit. However, improvement in patients with absent or low amplitude SNAP at the first visit was only observed in proximal sensory latency (P<0.005) and amplitude (P<0.003). Conclusion: There is a considerable chance for non-surgical improvement of patients with severe CTS in terms of symptom relief, hand function, and EDX parameters in those with detectable SNAP at the first visit; however, patients with undetectable SNAP have little, if any, the chance for improvement with conservative measures.

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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

Cited by 5 publications

References 18 publications

Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

Comparing the effectiveness of ultrasound-guided versus blind steroid injection in the treatment of severe carpal tunnel syndrome

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome

Revisiting the Urge to Operate: One-year Neurophysiological Follow-up in Severe CTS

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