Predictors of Surgical Outcomes Following Anterior Transposition of Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review

Shi, Qiyun; MacDermid, Joy C.; Santaguida, Pasqualina; Kyu, Hmwe Hmwe

doi:10.1016/j.jhsa.2011.09.024

Cited by 52 publications

(33 citation statements)

References 36 publications

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“…Numerous studies have attempted to use electrodiagnostics to predict prognosis in cubital tunnel syndrome, although all have relied on subjective postoperative outcomes 25,26,44,45 . Shi et al studied 73 patients who underwent ulnar nerve transposition and found that higher CMAP amplitude predicted greater postoperative improvement in self-reported symptoms, assessed by the patient-rated ulnar elbow evaluation (PRUNE) score 25 .…”

Section: Role Of Electrodiagnostic Studies In Surgical Planning and Dmentioning

confidence: 99%

Compound Muscle Action Potential Amplitude Predicts the Severity of Cubital Tunnel Syndrome

Power

Sharma

El-Haj

et al. 2019

The Journal of Bone and Joint Surgery

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Compound muscle action potential amplitude predicts the severity of cubital tunnel syndrome.Background: Cubital tunnel syndrome has a spectrum of presentations ranging from mild paresthesias to debilitating numbness and intrinsic atrophy. Commonly, the classification of severity relies on clinical symptoms and slowing of conduction velocity across the elbow. However, changes in compound muscle action potential (CMAP) amplitude more accurately reflect axonal loss. We hypothesized that CMAP amplitude would better predict functional impairment than conduction velocity alone.Methods: A retrospective cohort of patients who underwent a surgical procedure for cubital tunnel syndrome over a 5year period were included in the study. All patients had electrodiagnostic testing performed at our institution. Clinical and electrodiagnostic variables were recorded. The primary outcome was preoperative functional impairment, defined by grip and key pinch strength ratios. Multivariable regression identified which clinical and electrodiagnostic variables predicted preoperative functional impairment.Results: Eighty-three patients with a mean age of 57 years (75% male) were included in the study. The majority of patients (88%) had abnormal electrodiagnostic studies. Fifty-four percent had reduced CMAP amplitude, and 79% had slowing of conduction velocity across the elbow (recorded from the first dorsal interosseous). On bivariate analysis, older age and longer symptom duration were significantly associated (p < 0.05) with reduced CMAP amplitude and slowing of conduction velocity across the elbow, whereas body mass index (BMI), laterality, a primary surgical procedure compared with revision surgical procedure, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores, and visual analog scale (VAS) scores for pain were not. Multivariable regression analysis demonstrated that reduced first dorsal interosseous CMAP amplitude independently predicted the loss of preoperative grip and key pinch strength and that slowed conduction velocity across the elbow did not. Conclusions:Reduced first dorsal interosseous amplitude predicted preoperative weakness in grip and key pinch strength, and isolated slowing of conduction velocity across the elbow did not. CMAP amplitude is a sensitive indicator of axonal loss and an important marker of the severity of cubital tunnel syndrome. It should be considered when counseling patients with regard to their prognosis and determining the necessity and timing of operative intervention.Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.Disclosure: There was no source of external funding for this study. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article

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Section: Role Of Electrodiagnostic Studies In Surgical Planning and Dmentioning

confidence: 99%

Compound Muscle Action Potential Amplitude Predicts the Severity of Cubital Tunnel Syndrome

Power

Sharma

El-Haj

et al. 2019

The Journal of Bone and Joint Surgery

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“…Previous studies use a classification for Newcastle-Ottawa Scale as follows: 7 to 9 points considered as high quality; 5 to 6 points considered as moderate quality; and 0 to 4 points considered as low quality. 10 …”

Section: Study Identification and Validity Assessmentmentioning

confidence: 99%

Delirium in Acute Stroke

Shi

Presutti

Selchen

et al. 2012

Stroke

Self Cite

176

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Background and Purpose-Delirium is common in the early stage after hospitalization for an acute stroke. We conducted a systematic review and meta-analysis to evaluate the outcomes of acute stroke patients with delirium. Methods-We searched MEDLINE, EMBASE, CINAHL, Cochrane Library databases, and PsychInfo for relevant articles published in English up to September 2011. We included observational studies for review. Two reviewers independently assessed studies to determine eligibility, validity, and quality. The primary outcome was inpatient mortality and secondary outcomes were mortality at 12 months, institutionalization, and length of hospital stay. Results-Among 78 eligible studies, 10 studies (nϭ2004 patients) met the inclusion criteria. Stroke patients with delirium had higher inpatient mortality (OR, 4.71; 95% CI, 1.85-11.96) and mortality at 12 months (OR, 4.91; 95% CI, 3.18 -7.6) compared to nondelirious patients. Patients with delirium also tended to stay longer in hospital compared to those who did not have delirium (mean difference, 9.39 days; 95% CI, 6.67-12.11) and were more likely to be discharged to a nursing homes or other institutions (OR, 3.39; 95% CI, 2.21-5.21). Conclusions-Stroke patients with development of delirium have unfavorable outcomes, particularly higher mortality, longer hospitalizations, and a greater degree of dependence after discharge. Early recognition and prevention of delirium may improve outcomes in stroke patients. (Stroke. 2012;43:645-649.)

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“…There is limited research about factors that influence outcome after ulnar nerve decompression and those that are available show no conclusive result [8], which is in contrast to CTS where risk factors for development and for outcome of surgery are described [9,10].…”

Section: Findings Introductionmentioning

confidence: 98%

Outcome of simple decompression of the compressed ulnar nerve at the elbow – influence of smoking, gender, and electrophysiological findings

Dahlin

Andersson

et al. 2016

Journal of Plastic Surgery and Hand Surgery

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Predictors of Surgical Outcomes Following Anterior Transposition of Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review

Cited by 52 publications

References 36 publications

Compound Muscle Action Potential Amplitude Predicts the Severity of Cubital Tunnel Syndrome

Compound Muscle Action Potential Amplitude Predicts the Severity of Cubital Tunnel Syndrome

Delirium in Acute Stroke

Outcome of simple decompression of the compressed ulnar nerve at the elbow – influence of smoking, gender, and electrophysiological findings

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