Carpal tunnel decompression in patients with normal nerve conduction studies.

Area of Science:

• Orthopedics
• Neurology
• Clinical Outcomes Research

Background:

• Carpal tunnel syndrome (CTS) diagnosis can be challenging, with some patients exhibiting typical symptoms but normal nerve conduction studies (NCS).
• These patients often undergo surgical decompression despite inconclusive NCS findings, typically after conservative treatments fail.

Purpose of the Study:

• To compare the preoperative and 1-year postoperative functional outcomes, measured by QuickDASH scores, in patients with CTS who underwent carpal tunnel decompression.
• Specifically, to evaluate differences between patients with normal NCS and those with abnormal NCS.

Main Methods:

• A retrospective study included 637 patients who underwent carpal tunnel decompression.
• Patients were divided into two groups: those with typical CTS symptoms and normal NCS (n=19), and those with abnormal NCS.
• Preoperative and 1-year postoperative QuickDASH scores were collected and compared between the groups.

Main Results:

• Preoperative QuickDASH scores were similar between the normal NCS (58) and abnormal NCS (54.8) groups.
• At 1 year postoperatively, QuickDASH scores were significantly higher in the normal NCS group (34.9) compared to the abnormal NCS group (21.5).
• The improvement in QuickDASH scores (change from preoperative) was significantly less in the normal NCS group (23.1) than in the abnormal NCS group (33.4).

Conclusions:

• Patients with carpal tunnel syndrome and normal NCS experience significant functional improvement after decompression surgery.
• However, the degree of functional recovery is significantly less pronounced compared to patients with abnormal NCS.
• This suggests that while surgery can be beneficial, the long-term outcomes may differ based on electrodiagnostic findings in CTS.