Staged versus simultaneous bilateral endoscopic carpal tunnel release: an outcome study

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures

Background:

• Carpal tunnel syndrome (CTS) is a common condition often treated with surgical release.
• Endoscopic carpal tunnel release is a minimally invasive option.
• Comparing simultaneous bilateral versus staged surgical approaches is crucial for patient management.

Purpose of the Study:

• To compare the outcomes of bilateral simultaneous endoscopic carpal tunnel release with staged release.
• To evaluate patient outcomes using the Levine-Katz instrument and physical measurements.

Main Methods:

• Seventy-one patients were assessed preoperatively and at 6 months postoperatively.
• Three groups were studied: simultaneous bilateral release, staged release (1-3 weeks apart), and staged release (>3 weeks apart).
• Data collected included demographic information, symptom severity, physical tests (Semmes-Weinstein, grip/pinch strength, Tinel's, Phalen's), Levine-Katz scores, and patient satisfaction.

Main Results:

• Demographics were similar, though the simultaneous group had more men and younger patients.
• Preoperative symptom severity and physical measurements were comparable across all groups.
• All groups showed similar improvements in physical measurements, symptom severity, and functional status scores postoperatively.
• No significant differences were observed in complication rates or patient satisfaction between the groups.

Conclusions:

• Bilateral simultaneous endoscopic carpal tunnel release yields outcomes similar to staged procedures in selected patients.
• Simultaneous surgery may offer advantages such as a reduced period of disability and an earlier return to work.