Related Experiment Video
Updated: Aug 16, 2025
04:08
Metacarpal Small Incision for Carpal Tunnel Syndrome
Published on: April 5, 2024
565
Intraoperative Nerve Conduction Studies During Open Carpal Tunnel Release: A Pilot Study
Dominick V Congiusta1, Michael Yeranosian1, Kamil M Amer1
1Rutgers Health - New Jersey Medical School Department of Orthopaedics, Newark, NJ.
Eplasty
|December 22, 2022
Summary
This pilot study found no immediate difference in nerve conduction velocity (NCV) after carpal tunnel syndrome (CTS) surgery, regardless of whether only the transverse carpal ligament (TCL) or both TCL and volar antebrachial fascia (VAF) were released. Intraoperative NCV may not be a reliable indicator of surgical improvement.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Hand Surgery
Background:
- Carpal tunnel syndrome (CTS) surgery typically involves releasing the transverse carpal ligament (TCL) and sometimes the volar antebrachial fascia (VAF).
- Limited evidence exists comparing the outcomes of TCL release versus combined TCL and VAF release for CTS.
- This study investigated intraoperative nerve conduction velocity (NCV) changes following different surgical decompression extents in CTS patients.
Purpose of the Study:
- To measure intraoperative nerve conduction velocity (NCV) changes after carpal tunnel syndrome (CTS) surgery.
- To compare the outcomes of releasing only the transverse carpal ligament (TCL) versus releasing both the TCL and volar antebrachial fascia (VAF).
- To assess the utility of intraoperative NCV in evaluating surgical decompression effectiveness.
Main Methods:
- A pilot study included 10 patients aged 18-65 with idiopathic CTS unresponsive to conservative treatment.
- Exclusion criteria included prior surgery, diabetes, acute CTS, trauma, or cervical radiculopathy.
- Intraoperative motor and sensory nerve conduction parameters were recorded at baseline, after TCL release, and after TCL+VAF release.
Main Results:
- No significant intraoperative changes in mean motor or sensory amplitude and latency were observed.
- This lack of change was consistent across baseline, TCL release, and TCL+VAF release measurements.
- The findings indicate no immediate detectable difference in NCV with varying degrees of surgical decompression.
Conclusions:
- Intraoperative nerve conduction velocity (NCV) may not be a reliable tool for assessing immediate surgical improvement in carpal tunnel syndrome (CTS).
- Further case-control studies with larger patient cohorts and multiple hand specialists are needed to determine the true utility of intraoperative NCV.
- The study highlights the need for refined methods to evaluate surgical decompression efficacy during CTS operations.
