Minimally Invasive Ultrasound-Guided Carpal Tunnel Release Improves Long-Term Clinical Outcomes in Carpal Tunnel Syndrome

Kamel, Sarah; Freid, Bradley; Pomeranz, Corbin; Halpern, Ethan J.; Nazarian, Levon N.

doi:10.2214/ajr.20.24383

Cited by 27 publications

(54 citation statements)

References 31 publications

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“…Although not formally studied, an immediate reduction of their specific symptoms was additionally observed promptly after CT-release and during the follow-up examination. This positive effect with quick improvement of hand function and reduction of hand discomfort was also demonstrated in a recent study by Kamel et al [ 18 ].…”

Section: Discussionsupporting

confidence: 77%

Ultrasound-Guided Minimal Invasive Carpal Tunnel Release: An Optimized Algorithm

Loizides

Honold

Skalla-Oberherber

et al. 2021

Cardiovasc Intervent Radiol

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Purpose To present a safety-optimized ultrasound-guided minimal invasive carpal tunnel release (CTR) procedure. Materials and Methods 104 patients (67 female, 37 male; mean age 60.6 ± 14.3 years, 95% CI 57.9 to 63.4 years) with clinical and electrophysiological verified typical carpal tunnel syndrome were referred for a high-resolution ultrasound of the median nerve and were then consecutively assigned for an ultrasound-guided CTR after exclusion of possible secondary causes of carpal tunnel syndrome such as tumors, tendovaginitis, ganglia and possible contraindications (e.g., crossing collateral vessels, nerve variations). Applying a newly adapted and optimized algorithm, basing on the work proposed by Petrover et al. CTR was performed using a button tip cannula which has several safety advantages: On the one hand, the button tip cannula acts as a blunt and atraumatic guiding splint for the subsequent insertion of the hook-knife, and on the other hands, it serves as a “hydro-inflation”-tool, i.e., a fluid-based expansion of the working-space is warranted during the whole procedure whenever needed. Results In all patients, successful releases were confirmed by the depiction of a completely transected transverse carpal ligament during and in the postoperative ultrasound-controls two weeks after intervention. All patients reported markedly reduction of symptoms promptly after this safety-optimized ultrasound-guided minimal invasive CTR and at the follow-up examination. No complications were evident. Conclusion The here proposed optimized algorithm assures a reliable and safe ultrasound-guided CTR and thus should be taken into account for this minimal invasive interventional procedure.

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Section: Discussionsupporting

confidence: 77%

Ultrasound-Guided Minimal Invasive Carpal Tunnel Release: An Optimized Algorithm

Loizides

Honold

Skalla-Oberherber

et al. 2021

Cardiovasc Intervent Radiol

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“…Clinically preferable treatments for mild to moderate CTS include wrist splinting, therapeutic ultrasonography, and oral medicines. However, these treatments have short-term sustained efficacy and patients are susceptible to recurrence [ 4 ]. Surgical treatments have some efficacy but also bring about complications such as postoperative pain and weakness.…”

Section: Introductionmentioning

confidence: 99%

Effect of Acupotomy Combined with Electroacupuncture Therapy on Finger Mobility and Pain Relief in Patients with Carpal Tunnel Syndrome

Li¹,

Kou²,

Zhang³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. To explore the effect of acupotomy in combination with electroacupuncture therapy on the finger mobility and pain relief in patients who had carpal tunnel syndrome (CTS). Methods. The clinical data of 60 CTS patients in our hospital from November 2020 to November 2021 received retrospective analysis. With 30 cases in each group, they were randomly divided into the treatment group and the control group. The control group underwent hot compress, oral medication, and local injection during hospitalization, while the treatment group received acupotomy and electroacupuncture therapy on top of the above treatments, and the clinical effects, finger mobility, and pain relief were compared between both groups. Results. The clinical indexes in the treatment group after treatment were remarkably better than those in the control group ( P < 0.05 ), with the remarkably higher number of cured cases in the treatment group ( P < 0.05 ). After treatment, the treatment group had remarkably higher mean total active motion (TAM) and score of the 36-item short form (SF-36) health survey and a remarkably lower mean score of visual analog scale (VAS) than those in the control group ( P < 0.001 ). Conclusion. The quality of life and finger mobility of CTS sufferers can be improved with acupotomy in conjunction with electroacupuncture therapy. In-depth research will help build better procedures for these patients because this approach lessens the discomfort and shortens the symptom duration in CTS sufferers.

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“…29 The CSA of the median nerve at the carpal tunnel was reported as the greatest CSA obtained between the scaphoid-pisiform and trapezium-hamate levels, or alternatively at the level of the distal wrist crease. 29,32 The CSA is measured and compared with the CSA of the median nerve in the distal third of the forearm, volar and superficial to the pronator quadratus muscle. 29 The mean CSA of the median nerve as measured with US in healthy normal subjects can range from 6.1 to 10.4 mm 2 at the carpal tunnel.…”

Section: Imaging Of Nerve Entrapmentmentioning

confidence: 99%

“…30 In addition, the role of US as a guidance tool for interventions, such as cortisone injection therapy or minimally invasive carpal tunnel release, has been recognized. 30 32 US parameters include thickening and bowing configuration of the retinaculum and abnormal echogenicity of the median nerve at the carpal tunnel. 29 The CSA of the median nerve at the carpal tunnel was reported as the greatest CSA obtained between the scaphoid-pisiform and trapezium-hamate levels, or alternatively at the level of the distal wrist crease.…”

Section: Imaging Of Nerve Entrapmentmentioning

confidence: 99%

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Ultrasonographic Evaluation of Peripheral Nerves: Technical Considerations

Greenfield

Parrikh

Kanesa-Thasan

2022

Semin Musculoskelet Radiol

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Advances in ultrasonographic (US) technology featuring high-resolution transducers have revolutionized US over recent years as a modality increasingly used in the evaluation of musculoskeletal structures and peripheral nerves. A wide variety of nerve pathologies can be detected, such as neoplastic and tumorlike lesions, entrapment syndromes, posttraumatic injuries, and inflammatory conditions. US can serve as an imaging tool for guiding percutaneous treatments, such as injection therapies or hydrodissection, and assist with perioperative nerve marking and visualization of peripheral nerves in the operating room. This article describes the normal US appearance of peripheral nerves, US imaging techniques, common peripheral nerve pathologies, and interventional applications.

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Minimally Invasive Ultrasound-Guided Carpal Tunnel Release Improves Long-Term Clinical Outcomes in Carpal Tunnel Syndrome

Cited by 27 publications

References 31 publications

Ultrasound-Guided Minimal Invasive Carpal Tunnel Release: An Optimized Algorithm

Ultrasound-Guided Minimal Invasive Carpal Tunnel Release: An Optimized Algorithm

Effect of Acupotomy Combined with Electroacupuncture Therapy on Finger Mobility and Pain Relief in Patients with Carpal Tunnel Syndrome

Ultrasonographic Evaluation of Peripheral Nerves: Technical Considerations

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