Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study

Abstract

Background: Perineural injection therapy with 5% dextrose water (D5W) is a potential and innovative treatment with long-term efficacy for carpal tunnel syndrome (CTS). However, the prognostic factors of this management are lacking; hence, the aim of this retrospective study was to identify the prognostic factors of D5W perineural injection therapy for mild-to-moderate CTS. Methods: A total of 52 patients (52 wrists) diagnosed with mild-to-moderate CTS and treated with a single ultrasound-guided 5cc D5W perineural injection were retrospectively reviewed. Patient-reported injection outcomes (visual analog scale, VAS) at 6 months post-injection were categorized into two groups; (1) Good outcome, when symptom relief ≥50% compared to pre-injection and (2) Poor outcome, when symptom relief < 50% compared to pre-injection. Significant variables between groups were entered into a binary logistic regression with forward stepwise regression to determine the prognostic factors for these outcomes. Results: The treatment outcome was significantly related to body height and sensory nerve conduction velocity (SNCV) (159.1 ± 1.0 vs. 155.0 ± 1.8, p=0.04; 33.6 ± 0.8 vs. 28.3 ± 1.2, p=0.001, good vs. poor outcomes). However, only SNCV remained significantly correlated with the outcomes after conducting stepwise logistic regression (ORs: 1.201; 95% CI 1.05-1.38; p=0.01). Conclusions: SNCV was found to be a significant prognostic factor of treatment outcome for patients with mild-to-moderate CTS 6 months after a D5W perineural injection.

Novel Motor-Sparing Ultrasound-Guided Neural Injection in Severe Carpal Tunnel Syndrome: A Comparison of Four Injectates

“…Likewise, the long-term effect of D5W injection has also be confirmed in Li's retrospective study in which 88.6% of 185 patients reported symptom relief more than 50% after a mean of 2.2 injections with a mean of 1–3 years' postinjection follow-up without any adverse effect [ 38 ]. Recently, Ho et al [ 40 ] reported sensory nerve conduction velocity of the MN was found to be an independent prognostic factor (odds ratio: 1.201) of poor outcome postperineural injection with D5W.…”

Pelvic Osteotomies in Children and Adults - Experience of University Medical Centre Ljubljana

“…Likewise, they retrospectively found that body height and sensory nerve conduction velocity of the median nerve were risk factors for poor outcomes after PIT with D5W in patients with mild-to-moderate CTS. Moreover, the sensory nerve conduction velocity of the median nerve was found to be an independent prognostic factor of poor outcome (Ho et al, 2021). Nevertheless, the electrophysiological study presented a limited diagnosis of CTS with varied sensitivity (56% to 85%) and specificity (94% to 96%) (Witt et al, 2004; Jablecki et al, 2002).…”

Efficacy of 5% Dextrose Water Injection for Peripheral Entrapment Neuropathy: A Narrative Review

“…Likewise, they retrospectively found that body height and sensory nerve conduction velocity of the median nerve were risk factors for poor outcomes after PIT with D5W in patients with mild-to-moderate CTS. Moreover, the sensory nerve conduction velocity of the median nerve was found to be an independent prognostic factor (odds ratio, 1.201) of poor outcome [47]. Nevertheless, the electrophysiological study presented a limited diagnosis of CTS with varied sensitivity (56% to 85%) and specificity (94% to 96%) [48,49].…”