Carpal Tunnel Syndrome Treatment and the Subsequent Alterations in Median Nerve Transverse Mobility

Abstract

Objectives-The mobility (transverse movement) of the median nerve (MN) is decreased in patients with carpal tunnel syndrome and can be measured noninvasively by ultrasound. To date, there are few prognostic features to help predict the outcome of 2 commonly performed treatments: surgical carpal tunnel release and corticosteroid injection. This study aimed to assess the changes in nerve mobility after the intervention and to correlate this with treatment and the disease severity.Methods-A total of 181 patients with carpal tunnel syndrome with different electrophysiologic severities were recruited and assessed by dynamic ultrasound scanning of the MN before and after treatment. The dynamic ultrasound images were collected while the patients performed finger and wrist flexion.Results-For both injection and carpal tunnel release, the nerve displacement increased with wrist flexion, from a mean AE SD of 7.0 AE 2.4 to 7.9 AE 2.7 mm (P < .005). Patients who underwent surgery showed greater improvement (P < .005) in nerve mobility compared to those who underwent injection. We also observed that the increase in nerve mobility was predominantly in patients with more nerve damage at baseline.Conclusions-This study shows that the dynamic behavior of the MN changes in response to treatment and lays a foundation for future studies to assess the prognostic potential of nerve mobility measurement.

Effect of Perineural Injection with Different Dextrose Volumes on Median Nerve Size, Elasticity and Mobility in Hands with Carpal Tunnel Syndrome

“…Hence, treatments such as hydrodissection to directly influence median nerve excursion may play an important role. Hydrodissection enhanced nerve excursion through mechanical separation of subsynovial connective tissue(SSCT) [ 19 ]. In aspect of mechanical concept, cadaveric study assessing the biomechanical change founded the peak gliding resistance reduced after median nerve hydrodissection [ 12 ].…”

Efectividad de la Six-Item Carpal Tunnel Symptoms Scale para el diagnóstico del síndrome del túnel carpiano

“…1 Se caracteriza por un cuadro clínico inicial de dolor, entumecimiento y parestesias en el pulgar, índice, dedo medio y el lado radial del dedo anular que pueden llevar a debilidad de la mano, la disminución de la coordinación motora fina y la atrofia tenar. 2 Se diagnostica clínicamente mediante la anamnesis y el examen físico, y se suele confirmar con estudios de la conducción nerviosa, como la electromiografía.…”