Electrodiagnostic Studies in the Surgical Treatment of Carpal Tunnel Syndrome—A Systematic Review

Abstract

The aim of our paper was to provide comprehensive data on the role of electrodiagnostic (EDX) studies in the surgical treatment of carpal tunnel syndrome (CTS). An extensive search was conducted through the major electronic database to identify eligible articles. Data extracted included grade of CTS based on neurophysiological testing, preoperative data of EDX studies, time of complete or partial resolution after surgery, postoperative Boston carpal tunnel questionnaire (CTQ) scores, age, sex, intraoperative and postoperative data of EDX studies, time to complete or partial resolution of symptoms, and number of patients without postsurgical improvement. Our main findings revealed that that electrodiagnostic testing is still a powerful tool for diagnosis of CTS. Moreover, it can also detect other pathologies. EDX testing provides a quantitative measure of the physiological function of the median nerve, which may be used to guide surgical treatment. Thirdly, when the outcome of surgery is unsatisfactory, NCS can assist in determining the reason for failure.

Carpal Tunnel Syndrome and Diabetes—A Comprehensive Review

“…In previous studies, 70% of all patients with CTS had undergone electrophysiology testing before surgery [ 70 ]. A general agreement seems to be that electrophysiology is not necessary in uncomplicated cases, but can aid in differential diagnosis and in prognosticating surgical outcomes [ 71 ], which might be crucial in individuals with diabetes.…”

The Relevance of Collision Tests and Quantitative Sensory Testing in Diagnostics and Postoperative Outcome Prediction in Carpal Tunnel Syndrome

“…Analysis of standard motor and sensory conduction showed persistent and significant differences in postoperative electrophysiological values when compared to the control group. Standard electrophysiology allows an assessment of only the biggest and fastest nerve fibers ( 15 , 16 ). In CVD, which allows assessment of the function of motor fibers of different diameter, we also found much worse results after the operation than in the controls.…”

“…Ultimately, the study group consisted of 35 patients, 3 patients dropped out from the study. CTS recognition was based on clinical and electrophysiological criteria ( 4 , 5 , 12 , 14 , 15 ), e.g., clinical symptoms were present, and NCS allowed the recognition of CTS in accordance with American Association of Electrodiagnostic Medicine guidelines ( 12 ), and with use of the Padua neurophysiological classification ( 7 ). None of the patients had coexisting medical problems influencing the peripheral nerve function.…”

Carpal tunnel syndrome: state-of-the-art review

“…Electrodiagnostic studies (EDX) include nerve conduction studies and electromyography. NCS confirm CTS by detecting impaired median nerve conduction across the carpal tunnel, the so called median neuropathy at the wrist (MNW) with normal conduction elsewhere [55,70]. Every patient with suspected CTS should undergo NCS before invasive treatment to confirm the diagnosis.…”