Clinical experience with the CO2 laser during carpal tunnel decompression

Scar tissue formation along the cut edges of the transverse carpal ligament has been found to be among the primary causes for persistent median nerve compression following carpal tunnel release with the steel scalpel. Since laser surgery has been shown to be effective in reducing incisional inflammatory reactions, hypertrophic scarring, and postoperative pain and edema, in achieving better hemostasis, the application of the carbon dioxide laser may be a more efficient surgical tool than the steel scalpel for carpal tunnel release. In 46 cases of carpal tunnel syndrome, the carbon dioxide laser was utilized to vaporize the transverse carpal ligament and seal its edges. The patients were then reevaluated at 1 week, 2 weeks, 6 months, 1 year, and 2 years. No intraoperative complications were encountered. Patients reported minimal postoperative pain, rapid return of sensibility, decreased paresthesia, and increased motor function. After 2 years, there have been no recurrent symptoms of median nerve compression in these patients.