Abstract
The purpose of this study is to present the surgical outcome of endoscopic carpal
tunnel release (ECTR) for the treatment of carpal tunnel syndrome (CTS). One hundred
and thirty-one procedures (36 right hands, 33 left hands and 31 bilateral hands) of
single portal ECTR were performed upon 100 patients (age range: 36 - 77 years, mean
age: 52.9 years; 98 women and 2 men) with electrodiagnostically proven CTS for 2.5
years from 2001. Preoperative clinical severity and results of electrodiagnostic studies
were compared with surgical outcomes at the minimal 3-month postoperative period.
Among 131 cases 125 (95.4 %) with complete or significant relief of symptoms were
satisfied and 6 (4.6 %) with partial or no relief of symptoms were dissatisfied. There
were 2 cases of major complications (one with ulnar nerve injury and the other with
ulnar artery injury) that developed in our early experience of ECTR and 1 case of
recurrence. The grade of electrodiagnostic abnormalities was associated with surgical
outcome but there was no statistical significance between them. The severity of clinical
findings, age at onset and symptom duration were not correlated with surgical outcome.
In conclusion, ECTR surgery was effective in relieving the symptoms of CTS with a
low complication rate after the learning curve period. Thus, ECTR can be an alternative
to the traditional open surgery and can be the first procedure for CTS with several
advantages over open methods.
Key words
Carpal tunnel syndrome - endoscopic carpal tunnel release - outcome - minimally invasive
surgery
References
- 1
Okutsu I, Ninomiya S, Takatori Y, Ugawa Y.
Endoscopic management of carpal tunnel syndrome.
Arthroscopy.
1989;
5
11-18
- 2
Filippi R, Reisch R, EI-Shki D, Grunert P.
Uniportal endoscopic surgery of carpal tunnel syndrome: technique and clinical results.
Minim Invasive Neurosurg.
2002;
45
78-83
- 3
Hasegawa K, Hashizume H, Senda M, Kawai A, Inoue H.
Evaluation of release surgery for idiopathic carpal tunnel syndrome: endoscopic versus
open method.
Acta Med Okayama.
1999;
53
179-183
- 4
Jimenez D F, Gibbs S R, Clapper A T.
Endoscopic treatment of carpal tunnel syndrome: a critical review.
J Neurosurg.
1998;
88
817-826
- 5
Nagle D J.
Endoscopic carpal tunnel release.
Hand Clin.
2002;
18
307-313
- 6
Okada M, Tsubata O, Yasumoto S, Toda N, Matsumoto T.
Clinical study of surgical treatment of carpal tunnel syndrome: Open versus endoscopic
technique.
J Orthop Surg (Hong Kong).
2000;
8
19-25
- 7
Trumble T E, Diao E, Abrams R A, Gilbert-Anderson M M.
Single-portal endoscopic carpal tunnel release compared with open release: a prospective,
randomized trial.
J Bone Joint Surg.
2002;
84
1107-1115
- 8
Trumble T E, Gilbert M, McCallister W V.
Endoscopic versus open surgical treatment of carpal tunnel syndrome.
Neurosurg Clin N Am.
2001;
12
255-266
- 9
Menon J.
Endoscopic carpal tunnel release: a single-portal technique.
Contemp Orthop.
1993;
26
109-116
- 10
Hirooka T, Hashizume H, Senda M, Nagoshi M, Inoue H, Nagashima H.
Adequacy and long-term prognosis of endoscopic carpal tunnel release.
Acta Med Okayama.
1999;
53
39-44
- 11
Stevens J C.
AAEM minimonograph #26: The electrodiagnosis of carpal tunnel syndrome.
Muscle Nerve.
1997;
20
1477-1486
- 12
Botte M J, Schroeder H P von, Abrams R A, Gellman H.
Recurrent carpal tunnel syndrome.
Hand Clin.
1996;
12
731-743
- 13
Strasberg S R, Novak C B, Mackinnon S E, Murray J F.
Subjective and employment outcome following secondary carpal tunnel surgery.
Ann Plast Surg.
1994;
32
485-489
- 14
Concannon M J, Brownfield M L, Puckett C L.
The incidence of recurrence after endoscopic carpal tunnel release.
Plast Reconstr Surg.
2000;
105
1662-1665
- 15
Forman D L, Watson H K, Caulfield K A, Shenko J, Caputo A E, Ashmead D.
Persistent or recurrent carpal tunnel syndrome following prior endoscopic carpal tunnel
release.
J Hand Surg [Am].
1998;
23
1010-1014
- 16 Shenko J, Watson H K, Forman D, Caulfield K. Recurrent carpal tunnel syndrome following
prior endoscopic carpal tunnel release (Abstract). American Society for Surgery of
the Hand, 52nd Annual Meeting. 1997
- 17
Nygaard O P, Trumpy J H, Mellgren S I.
Recovery of sensory function after surgical decompression in carpal tunnel syndrome.
Acta Neurol Scand.
1996;
94
253-257
- 18
Kiymaz N, Cirak B, Tuncay I, Demir O.
Comparing open surgery with endoscopic releasing in the treatment of carpal tunnel
syndrome.
Minim Invasive Neurosurg.
2002;
45
228-230
- 19
Schnek R R.
The role of endoscopic carpal tunnel release in the treatment of carpal tunnel syndrome.
Adv Plas Reconstr Surg.
1995;
11
17-43
- 20
Brief R, Brief L P.
Endoscopic carpal tunnel release: report of 146 cases.
Mt Sinai J Med.
2000;
67
274-277
- 21
Serra L, Panagiotopoulos K, Bucciero A, Mehrabi F K, Pescatore G, Santangelo M, Vizioli L.
Endoscopic release in carpal tunnel syndrome: analysis of clinical results in 200
cases.
Minim Invasive Neurosurg.
2003;
46
11-15
- 22
Straub T A.
Endoscopic carpal tunnel release: a prospective analysis of factors associated with
unsatisfactory results.
Arthroscopy.
1999;
15
269-274
- 23
Harris C M, Tanner E, Goldstein M, Pttee D S.
The surgical treatment of carpal tunnel syndrome correlated with preoperative nerve
conduction studies.
J Bone Joint Surg [Am].
1979;
61
193-198
- 24
Ueno H, Kaneko K, Taguchi T, Fuchigami Y, Fujimoto H, Kawai S.
Endoscopic carpal tunnel release and nerve conduction studies.
Int Orthop.
2001;
24
361-363
- 25
Glowacki K A, Breen C J, Sachar K, Weiss A P.
Electrodiagnostic testing and carpal tunnel syndromes outcome.
J Hand Surg [Am].
1996;
21
117-121
Se-Hyuck ParkM. D.
Department of Neurosurgery · Kangdong Sacred Heart Hospital · Hallym University College
of Medicine
#445 · Gil-dong · Gangdong-gu
Seoul, 134-701
Korea
Phone: +82-2-2224-2238 ·
Fax: +82-2-473-7387
Email: sehyuck@hallym.or.kr