Cross-sectional area of the ulnar nerve after decompression at the cubital tunnel

Duetzmann, Stephan; Krishnan, Kartik G.; Staub, Frank; Kang, Ji-Hyuk; Seifert, Volker; Marquardt, Gerhard

doi:10.1177/1753193416635803

Cited by 10 publications

(7 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study confirms the recent reports of Duetzmann et al 33 in open and endoscopic cubital tunnel release: lower CSA reduction of the ulnar nerve at the elbow seems to be not so strongly associated with clinical improvement, unlike previous studies of the median nerve. [34][35][36] This lack of important reduction in CSA in ulnar nerve decompression is probably related to a irreversible fibrosis rather than a reversible endoneurinal edema in long lasting CuTS.…”

Section: Discussionsupporting

confidence: 91%

“…Beekman et al 32 reported in 2004 that the mean values of the ulnar nerve were reduced to only 90% of the pre-operative value at 14 months follow-up. While Duetzmann et al 33 found a CSA reduction to 93% (12.9 mm 2 ± 2.3, paired t-test, P-value < 0.001) of the pre-operative value at 46 months follow-up in 73 patients treated by either endoscopic or open surgical decompression. Although with satisfactory results (54% of excellent results, 22% good, 20% fair and 4% poor) the lack of reduction of CSA might be due to the number of patients with a high severity compression grade in the study of Duetzmann et al 33 In contrast with these results, a greater reduction of the CSA of the median nerve has been reported in carpal tunnel release by Abicalaf et al 34 (6.4 mm 2 ), Vögelin et al 35 (3.2 mm 2 ) and Tas et al 36 (2.3 mm 2 ± 3.4 mm 2 ).…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Lucchina

Fusetti

Guidi

2019

Hand (New York, N,Y.)

View full text Add to dashboard Cite

Background:The measurement of cross-sectional area (CSA) is a diagnostic tool to detect entrapments syndrome. The aim of this study was to compare the clinical outcome in elbows undergoing endoscopic and “in situ” open cubital tunnel release for cubital tunnel syndrome (CuTS) using ultrasound-related changes in the largest CSA of the ulnar nerve. The purpose is to determine the association between clinical outcome and CSA. Methods: From May 2011 to April 2016, 60 patients with CuTS were prospectively followed and not randomly divided in two groups: 30 patients undergoing an endoscopic release (ER) and 30 patients with “in situ” open neurolysis (OR). A sonographic examination was performed by the senior authors at baseline and 3, 6, and 12 months after surgical decompression. Results: CSA values were statistically significantly lower in the ER. Hand grip strength difference with Jamar test was not statistically significant a 12 months (39 kg vs 27 kg). Static-2 point discrimination test difference was only statistically significant lower in the endoscopic group at 3, 6 and 12 months but not clinically relevant (5 mm vs 6 mm). The American Shoulder and Elbow Surgeons—Elbow questionnaire (ASES-e) function score, ASES-e Pain score, and ASES-e Satisfaction score were not statistically significant different between the two groups at 3, 6, and 12 months post operatively. Conclusions: The study confirms that in spite of lower values of CSA in the ER, there is not a statistically significant difference between the two techniques in terms of subjective outcomes. Ultrasound (US) measurements seem to have a limited value in clinical results of patients treated for entrapment neuropathy of the ulnar nerve. Type of study/LOE: Prognostic Level III

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Lucchina

Fusetti

Guidi

2019

Hand (New York, N,Y.)

View full text Add to dashboard Cite

show abstract

“…In their study they found a slight reduction in the mean value of the cross-sectional area of the nerve. They draw a conclusion that ultrasound examination seems to be of limited in follow up after surgery [12]. In our investigation we saw higher reduction in cross-sectional area of the ulnar nerve postoperatively.…”

Section: Discussionsupporting

confidence: 50%

Anterior subcutaneous transposition and simple decompression of the ulnar nerve at the elbow – the postoperative improvement in DASH score, VAS score and sonographic findings

Adamski¹

2018

Chir. Narzadow Ruchu Ortop. Pol.

View full text Add to dashboard Cite

Introduction. Although a lot of studies have described long-term outcomes after surgical treatment of cubital tunnel syndrome, and the usefulness of sonography in diagnosing of this disorder, few studies have evaluated patients self-reporting outcomes or sonographic findings after surgery. Aim. We assessed patients self-reporting instruments and sonographic findings in patients with the cubital tunnel syndrome before and after a surgery. Materials and methods. Forty patients with moderate cubital tunnel syndrome admitted to an orthopedic department were included. Patients underwent an ultrasound examination, filled a DASH questionnaire before, three months and six months after the operation. They had also their symptoms rated with the VAS scale before and six months postoperatively. Patients with clinical signs of subluxation of the nerve during the operation were allocated to a "transposition" group. Patients without these signs had an in situ release. The statistical analyses were made using a nonparametric Friedman ANOVA test for DASH score and Wilcoxon matched-pairs signed-ranks test for VAS scale. Results. After the in situ release, there was a higher difference in the cross-sectional area of the nerve three months after operations than in the cases with a subcutaneous transposition, respectively 10.9 mm 2 and 12 mm 2. Patients satisfaction measured with the DASH questionnaire and the VAS scale showed that there was a statistically significant improvement after both operations. Conclusions. According to our results, both methods help patients to relieve their symptoms, but after a simple decompression, recovery, measured with patients' self-reporting instruments and with ultrasound examination, is faster.

show abstract

“…Like CTS, the EDX community would benefit from a modality that could determine the cause of symptoms that sometimes are present after an ulnar nerve release. The ulnar nerve usually decreases in size after surgery but remains abnormal 25,76 . If a preoperative CSA is available, an increase in size after surgery compared with a baseline value is unusual and could represent recurrent or incompletely decompressed UNE.…”

Section: Specific Conditionsmentioning

confidence: 99%

“…If a preoperative CSA is available, an increase in size after surgery compared with a baseline value is unusual and could represent recurrent or incompletely decompressed UNE. In addition, most studies show that the ulnar nerve size after surgery does not differ significantly between those with good and poor outcomes 25,66,76 . This limits the value of the CSA of the ulnar nerve after surgery when ulnar nerve symptoms are present.…”

Section: Specific Conditionsmentioning

confidence: 99%

Neuromuscular Ultrasound

Jorgensen

Cartwright

Norbury

2021

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Accurate assessment of neuromuscular disorders is critical to facilitate timely treatment and achieve the best outcomes. Historically, electrodiagnostic studies have filled this role, but recently, neuromuscular ultrasound is being used in the electrodiagnostic laboratory. This review discusses the uses of neuromuscular ultrasound in the electrodiagnostic laboratory that have strong evidence, emphasizing those that could be adopted in a typical electrodiagnostic laboratory with a reasonable level of equipment and training. The evidence currently supports using neuromuscular ultrasound to diagnose carpal tunnel syndrome and ulnar neuropathies at the elbow and as a supplementary test when electrodiagnostic studies are suspected to be falsely negative or in axonal nonlocalizing lesions. Neuromuscular ultrasound can identify the causes of focal mononeuropathies, which can change treatment in specific cases. It is sensitive at identifying fasciculations and providing complementary evidence of autoimmune demyelinating polyneuropathies. It is particularly helpful in assessing nerves after trauma. Neuromuscular ultrasound is likely to prove even more useful in the electrodiagnostic laboratory as the technology continues to advance.

show abstract

Cross-sectional area of the ulnar nerve after decompression at the cubital tunnel

Abstract: IV.

Cited by 10 publications

References 27 publications

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Sonographic Follow-Up of Patients With Cubital Tunnel Syndrome Undergoing in Situ Open Neurolysis or Endoscopic Release: The SPECTRE Study

Anterior subcutaneous transposition and simple decompression of the ulnar nerve at the elbow – the postoperative improvement in DASH score, VAS score and sonographic findings

Neuromuscular Ultrasound

Contact Info

Product

Resources

About