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Kim DH, Cho BM, Oh SM, et al. Delayed improvement after endoscopic carpal tunnel release. J Korean Neurosurg Soc. 2014;56(5):390-4doi: 10.3340/jkns.2014.56.5.390.
Kim, D. H., Cho, B. M., Oh, S. M., Park, D. S., & Park, S. H. (2014). Delayed improvement after endoscopic carpal tunnel release. Journal of Korean Neurosurgical Society, 56(5), 390-4. https://doi.org/10.3340/jkns.2014.56.5.390
Kim, Dong-Ho, et al. "Delayed improvement after endoscopic carpal tunnel release." Journal of Korean Neurosurgical Society vol. 56,5 (2014): 390-4. doi: https://doi.org/10.3340/jkns.2014.56.5.390
Kim DH, Cho BM, Oh SM, Park DS, Park SH. Delayed improvement after endoscopic carpal tunnel release. J Korean Neurosurg Soc. 2014 Nov;56(5):390-4. doi: 10.3340/jkns.2014.56.5.390. Epub 2014 Nov 30. PMID: 25535515; PMCID: PMC4272996.
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J Korean Neurosurg Soc. 2014 Nov;56(5):390-4. doi: 10.3340/jkns.2014.56.5.390. Epub 2014 Nov 30.

Delayed improvement after endoscopic carpal tunnel release.

Journal of Korean Neurosurgical Society

Dong-Ho Kim, Byung-Moon Cho, Sae-Moon Oh, Dong-Sik Park, Se-Hyuck Park

Affiliations

  1. Department of Neurosurgry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
  2. Department of Rehabilitation Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

PMID: 25535515 PMCID: PMC4272996 DOI: 10.3340/jkns.2014.56.5.390

Abstract

OBJECTIVE: In most patients with carpal tunnel syndrome (CTS), pain and/or paresthesia disappeared or decreased in a month after endoscopic carpal tunnel release (ECTR). However, subpopulation of patients showed delayed improvement following ECTR. We analyzed the delayed improvement hands to investigate the characteristics of those patients and to determine the predictable factors of delayed improvement.

METHODS: Single-portal ECTRs were performed in 1194 hands of 793 CTS patients from 2002 to 2011. Five-hundred seventy hands with minimal 1-year postoperative follow-up were included. We divided the 545 satisfied hands into early (group A) and delayed (group B) groups according to improvement period of 1 month. Demographic data, clinical severity and electrodiagnostic abnormality were compared between groups.

RESULTS: Group A included 510 hands and group B included 35 hands. In group B, 11 hands improved in 2 months, 15 hands in 3 months and 9 hands in 6 months, respectively. In group A/B, according to clinical severity, 60/1 hands were graded to I, 345/24 hands to II, 105/10 hands to III. In group A/B, based on electrodiagnostic abnormality, 57/3 hands were classified to mild, 221/11 hands to moderate and 222/21 hands to severe group. Statistical analysis between groups did not reach significance but electrodiagnostic or clinical severity had a tendency to affect the delayed response.

CONCLUSION: It is difficult to predict the factors contributing to postoperatively-delayed response in subpopulation of CTS patients. However, we recommend that postoperative observation for at least 6 months is necessary in patients without symptomatic improvement.

Keywords: Carpal tunnel syndrome; Delayed improvement; Endoscopy; Surgical decompression

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