Postoperative nerve conduction changes after open and endoscopic carpal tunnel release.

Area of Science:

• Neurology
• Neurosurgery
• Orthopedics

Background:

• Idiopathic carpal tunnel syndrome (CTS) is a common condition affecting the median nerve.
• Surgical intervention is a primary treatment for CTS, with open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR) being common methods.

Purpose of the Study:

• To compare the efficacy of OCTR versus ECTR in improving nerve conduction parameters in CTS patients.
• To assess changes in motor distal latency (MDL), sensory nerve conduction velocity (SCV), compound muscle action potential (CMAP), and sensory nerve action potential (SNAP) amplitudes post-surgery.

Main Methods:

• A study involving sixty-six hands of sixty-six patients diagnosed with idiopathic CTS.
• Patients were divided into ECTR and OCTR groups, with pre-operative and 1, 3, 6, and 12-month post-operative evaluations.
• Nerve conduction studies were performed to measure key electrophysiological parameters.

Main Results:

• No statistically significant differences in MDL, SCV, CMAP, or SNAP recovery were observed between ECTR and OCTR groups at any follow-up point.
• One patient in the ECTR group, who required conversion to OCTR, experienced delayed MDL and reduced CMAP amplitude.
• Electrophysiological improvements were noted in both surgical groups over the 12-month period.

Conclusions:

• Both ECTR and OCTR demonstrate comparable long-term improvements in nerve conduction for CTS patients.
• ECTR is associated with a potential risk of nerve damage, as evidenced by a case report.
• While overall recovery is similar, a slightly faster improvement trend may favor OCTR, though further investigation is warranted.