Post-Operative Assessment of Ulnar Nerve Tension Using Shear-Wave Elastography

Abstract

Background: Ulnar nerve compression at the elbow level is the second-most common entrapment neuropathy. The aim of this study was to use shear-wave elastography for the quantification of ulnar nerve elasticity in patients after ulnar nerve decompression with anterior transposition and in the contralateral non-operative side. Method: Eleven patients with confirmed diagnosis and ulnar nerve decompression with anterior transposition were included and examinations were performed on an AixplorerTM ultrasound system (Supersonic Imagine, Aix-en-Provence, France). Results: We observed significant differences at 0-degree (p < 0.001), 45-degree (p < 0.05), 90-degree (p < 0.01) and 120-degree (p < 0.001) elbow flexion in the shear elastic modulus of the ulnar nerve in the operative and non-operative sides. There were no statistically significant differences between the elasticity values of the ulnar nerve after transposition at 0-degree elbow flexion and in the non-operative side at 120-degree elbow flexion (p = 0.39), or in the ulnar nerve after transposition at 120-degree elbow flexion and in the non-operative side at 0-degree elbow flexion (p = 0.09). Conclusion: Shear-wave elastography has the potential to be used postoperatively as a method for assessing nerve tension noninvasively by the estimation of mechanical properties, such as the shear elastic modulus.

Diagnosis of ulnar nerve entrapment anterior to the medial epicondyle by ultrasound elastography and diffusion tensor imaging with fiber tractography: a case report

“…SWE confirmed the anterior location of the ulnar nerve relative to the rotation axis of the elbow, with a decreased tension in the ulnar nerve during elbow flexion: the values of the shear elastic modulus in the ulnar nerve decreased from 107.2 to 79.1 kPa with elbow flexion. These shear elastic modulus values were comparable to those recently reported in patients before and after anterior transposition of the ulnar nerve [ 5 ]. Due to the absence of extrinsic compression factors in this anterior nerve location, excessive friction and stretching are other potential mechanisms to consider.…”

In Vivo Effects of Joint Movement on Nerve Mechanical Properties Assessed with Shear-Wave Elastography: A Systematic Review and Meta-Analysis

“…The modified Downs and Black checklist score varied from 9 to 13. Five studies showed good quality (more than 11 points) [49,[52][53][54][55], and 11 showed fair quality (8-11 points) [36,37,50,[56][57][58][59][60][61][62][63]. None of the included studies scored below 9 points.…”

“…The characteristics of the 16 included studies are shown in Tables 2 and 3. In the upper extremity, the median nerve (MN) was assessed in six studies [36,37,55,[61][62][63], while the ulnar nerve (UN) was explored in three studies [37,57,60]. In the lower extremity, the sciatic nerve (SN) and the tibial nerve (TN) were evaluated in six studies [49,50,53,54,58,59] and four studies [36,52,54,56], respectively.…”

Neurosurgical Intervention for Nerve and Muscle Biopsies

“…This growing catalogue currently includes the ulnar nerve, [159] radial nerve, [160] and median nerve [161] among many others. Other studies, such as this one by Durand et al, 2021, have started comparing the elastic properties of healthy nerves against neuropathic nerves, in this case comparing entrapped ulnar nerves post decompression against the contralateral non-operative side [162].…”