Ultrasound evaluation on carpal tunnel syndrome before and after bariatric surgery

Abstract

Objective:To evaluate the prevalence of carpal tunnel syndrome in candidates for bariatric surgery comparing with the non-obese population and verify the effects on it of bariatric treatment. Methods:We studiedthree groups of individuals: 1) patients waiting for bariatric surgery (preoperative); 2) individuals who had already undergone the procedure (postoperative); and 3) control group. We collected demographic and clinical data of carpal tunnel syndrome. The Ultrasound examination was carried out to diagnose the syndrome by measuring the median nerve area. Results:We included 329 individuals (114 in the preoperative group, 90 in the postoperative group and 125 controls). There was a higher prevalence of paresthesias (p=0.0003), clinical tests (p=0.0083) on the preoperative group when compared with controls (p<0.00001). There were lowe levels of paresthesias (p=0.0002) and median nerve area (p=0.04) in postoperative patients but with no significant difference in general. A significant difference was found between the preoperative and postoperative groups (p=0.05) in those who performed non-manual work.Conclusion: There was a higher prevalence of carpal tunnel syndrome in the preoperative group compared with the control one, but no significant difference was observed between the pre and postoperative groups in general. There was difference between pre and postoperative groups for non-manual workers.

Subjective and Objective Differences in Patients with Unilateral and Bilateral Carpal Tunnel Syndrome and the Role of Obesity in Syndrome Severity

“…4,17,18 In this study, the investigation of obesity (BMI > 30 kg/m 2 ) as it relates to CTS showed that obesity significantly affects quantitative metrics (US and NCS) of CTS, but does not affect symptomatic severity (CTS-6 and BCTSQ). Like the US measurements in this analysis, Castro et al 19 identified that obese CTS patients have a significantly enlarged median nerve CSA on US in comparison to a control group. Furthermore, other studies agree that higher BMI values significantly impact NCS results in CTS cohorts.…”

“…It is possible that inflammation, mechanical compression of the median nerve, and microvascular injury because of obesity could have played a role in the results of this analysis. 19…”

“…It is possible that inflammation, mechanical compression of the median nerve, and microvascular injury because of obesity could have played a role in the results of this analysis. 19 The benefits of this study include the large sample size and a paired analysis between two hands of the same patient. Limitations of this study include its retrospective nature, lack of a control group of asymptomatic patients, and noninclusion of other known risk factors that are more severe in CTS, including neurologic and endocrine disorders.…”

Obesity, adiposopathy, and quantitative imaging biomarkers

“…Obesity plays an important role in the development of several diseases, such as atherosclerosis, diabetes, musculoskeletal conditions (e.g., osteoarthritis, tendinopathy, and carpal tunnel syndrome), and chronic pain (2-5) . Another important association is the increased risk of cancer (6,7) .…”