Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study

Vögelin, Esther; Nüesch, Eveline; Jüni, Peter; Reichenbach, Stephan; Eser, Prisca; Ziswiler, Hans‐Rudolf

doi:10.1016/j.jhsa.2010.06.010

Cited by 70 publications

(86 citation statements)

References 23 publications

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“…Whereas one study found an almost statistically significant correlation between CSA and clinical improvement, 15 we could not find any correlation. In our particular study this is due to the high number of patients with clinical improvement.…”

Section: Discussioncontrasting

confidence: 99%

“…Clinical, sonographic, and electrophysiological parameters were assessed, as shown in Table 1. Nerve CSA and age were post hoc dichotomized into ≥ 12 mm 2 or < 12 mm 2 and ≥ 65 years or < 65 years to compare our findings with those of Vögelin et al, 15 who found a statistically significant difference in CSA reduction in these groups. Surgical decompression was then performed either in open fashion or endoscopically.…”

Section: Methodsmentioning

confidence: 73%

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Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

Tas

Staub²,

Dombert³

et al. 2015

FOC

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OBJECT Carpal tunnel syndrome causes increased cross-sectional area (CSA) of the median nerve, which can be assessed by high-definition ultrasonography. It is unclear today, however, whether high-definition ultrasonography may play a role in the postoperative period. This prospective study aimed to determine the natural history of the morphology of the median nerve at the carpal tunnel after surgical decompression assessed by high-definition ultrasonography. METHODS Between October and December 2014, patients with suspected carpal tunnel syndrome who were referred to the authors’ center for peripheral neurosurgery were prospectively enrolled and underwent pre- and postoperative (3 months) high-definition ultrasonography, electrophysiology, and clinical testing. RESULTS Eighty-one patients were enrolled in the study, and 100% were clinically better at the 3-month follow-up. The mean CSA decreased from 14.7 ± 4.9 mm2 to 12.4 ± 3.4 mm2 (mean ± SD, p < 0.0001). The mean distal motor latency decreased from 6.6 ± 2.4 msec to 4.8 ± 1.0 msec (mean ± SD, p < 0.0001). Ninety-eight percent of patients who were available for electrodiagnostic follow-up showed an improvement of the distal motor latency; only 80% had a reduction in the CSA. CONCLUSIONS The authors present the second-largest series of patients with sonographic follow-up after surgical decompression of the carpal tunnel reported in the literature so far. This study, which showed a decrease in size of the median nerve after surgical decompression, suggests that the preoperative increase in median nerve CSA at the carpal tunnel may be due to compression and that enlargement of the median nerve is (partially) reversible.

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Section: Discussioncontrasting

confidence: 99%

Section: Methodsmentioning

confidence: 73%

Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

Tas

Staub²,

Dombert³

et al. 2015

FOC

View full text Add to dashboard Cite

show abstract

“…These advantages make ultrasonography a useful tool for making comparisons before and after surgery. Previous reports indicated that the enlarged median nerve CSA seen in CTS can shrink after surgery [12][13][14][15], and this is consistent with the present findings. About the displacement of median nerve induced by finger movement, Yoshii reported no significant changes after carpal tunnel release [16].…”

Section: Discussionsupporting

confidence: 93%

Ultasonographic indicators of carpal tunnel syndrome demonstrate reversibility following carpal tunnel release

Osada¹,

Zukawa²,

Kimura³

2018

Radiol Diagn Imaging

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“…In addition to its use in making an initial diagnosis of carpal tunnel syndrome, the practical applications for sonographic evaluation of the median nerve also include follow-up evaluation after conservative treatment and surgical intervention. For carpal tunnel syndrome of moderate severity or less, Kim et al 21 demonstrated a concurrent improvement in symptoms and a reduction in the median nerve size after carpal tunnel release, whereas Vögelin et al 22 demonstrated a concurrent improvement among patients with mild, moderate, and severe neurologic disease. As more radiologists and clinicians collectively become familiar with the sonographic technique, clinical examination combined with sonography will likely become an ever more routine approach for evaluating carpal tunnel syndrome.…”

Section: Discussionmentioning

confidence: 99%

Reliability Assessment of Various Sonographic Techniques for Evaluating Carpal Tunnel Syndrome

Junck

Escobedo

Lipa

et al. 2015

J of Ultrasound Medicine

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Objectives The aim of this study was to determine the intra- and inter-rater reliability of sonographic measurements of the median nerve cross-sectional area in individuals with carpal tunnel syndrome and healthy control participants. Methods The median nerve cross-sectional area was evaluated by sonography in 18 participants with carpal tunnel syndrome (18 upper extremities) and 9 control participants (18 upper extremities) at 2 visits 1 week apart. Two examiners, both blinded to the presence or absence of carpal tunnel syndrome, captured independent sonograms of the median nerve at the levels of the carpal tunnel inlet, pronator quadratus, and mid-forearm. The cross-sectional area was later measured by each examiner independently. Each also traced images that were captured by the other examiner. Results Both the intra- and inter-rater reliability rates were highest for images taken at the carpal tunnel inlet (radiologist, r = 0.86; sonographer, r = 0.87; inter-rater, r = 0.95; all P < .0001), whereas they was lowest for the pronator quadratus (r = 0.49, 0.29, and 0.72, respectively; all P < .0001). At the mid-forearm, the intra-rater reliability was lower for both the radiologist and sonographer, whereas the inter-rater reliability was relatively high (r = 0.54, 0.55, and 0.81; all P < .0001). Tracing of captured images by different examiners showed high concordance for the median cross-sectional area at the carpal tunnel inlet (r = 0.96–0.98; P < .0001). Conclusions The highest intra- and inter-rater reliability was found at the carpal tunnel inlet. The results also demonstrate that tracing of the median nerve cross-sectional area from captured images by different examiners does not contribute significantly to measurement variability.

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Sonographic Follow-Up of Patients With Carpal Tunnel Syndrome Undergoing Surgical or Nonsurgical Treatment: Prospective Cohort Study

Cited by 70 publications

References 23 publications

Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

Sonographic short-term follow-up after surgical decompression of the median nerve at the carpal tunnel: a single-center prospective observational study

Ultasonographic indicators of carpal tunnel syndrome demonstrate reversibility following carpal tunnel release

Reliability Assessment of Various Sonographic Techniques for Evaluating Carpal Tunnel Syndrome

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