Progression of Carpal Tunnel Syndrome According to Electrodiagnostic Testing in Nonoperatively Treated Patients | ||
The Archives of Bone and Joint Surgery | ||
مقاله 13، دوره 2، شماره 3، آذر 2014، صفحه 185-191 اصل مقاله (401.52 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2014.3231 | ||
نویسندگان | ||
Mark van Suchtelen؛ Stephanie Becker؛ Jillian S Gruber؛ David Ring* | ||
Massachusetts General Hospital | ||
چکیده | ||
Background: This study tested the null hypothesis that nonoperatively treated patients would not show disease progression of carpal tunnel syndrome (CTS) over time according to median nerve distal motor latency (DML) on two electrodiagnostic tests. Methods: This retrospective study analyzed sixty-two adult nonoperatively treated patients who were diagnosed with CTS confirmed by a minimum of two electrodiagnostic tests at our institution between December 2006 and tober 2012. A Wilcoxon signed-rank test was conducted to test the difference between electrodiagnostic measurements between the first and last test. Results: The mean time between the first and last electrodiagnostic test was 26±12 months (range, 12 to 55 months). The only electrodiagnostic measurement that increased significantly was the difference between median and ulnar DML on the same side (r=0.19, P =0.038). The time between the electrodiagnostic tests was significantly longer for patients with at least 10% worsening of the DML at the second test compared to cases of which the DML did not worsen or improve a minimum of 10% (P =0.015). Conclusions: There is evidence that—on average—idiopathic median neuropathy at the carpal tunnel slowly progresses over time, and this can be measured with electrodiagnostics, but studies with a much longer interval between lectrodiagnostic tests may be needed to determine if it always progresses. | ||
کلیدواژهها | ||
Carpal tunnel syndrome؛ Electrodiagnostic test؛ Nonoperative treatment؛ Progression؛ Upper extremity | ||
مراجع | ||
Diagnosis of the carpal tunnel syndrome. Lancet. 1985; 1:854-5.2.
Papanicolaou GD, McCabe SJ, Firrell J. The prevalence and characteristics of nerve compression symptoms in the general population. J Hand Surg Am. 2001; 26:460-6.
Hakim AJ, Cherkas L, El Zayat S, MacGregor AJ, Spector TD. The genetic contribution to carpal tunnel syndrome in women: a twin study. Arthritis Rheum. 2002; 47: 275-9.
Kulick RG. Carpal tunnel syndrome. Orthop Clin North Am. 1996; 27:345-54.
Ortiz-Corredor F, Enríquez F, Díaz-Ruíz J, Calambas N. Natural evolution of carpal tunnel syndrome in untreated patients.Clin Neurophysiol. 2008; 119:1373-8.
Graham RG, Hudson DA, Solomons M, Singer M. A prospective study to assess the outcome of steroid injections and wrist splinting for the treatment of carpal tunnel syndrome. Plast Reconstr Surg. 2004; 113:550-6.
Graham B. Nonsurgical treatment of carpal tunnel syndrome. J Hand Surg Am. 2009; 34:531-4.
Sevim S, Dogu O, Camdeviren H, Kaleagasi H, Aral M, Arslan E, et al. Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome. Neurol Sci. 2004; 25:48-52.
Brooks JJ, Schiller JR, Allen SD, Akelman E. Biomechanical and anatomical consequences of carpal tunnel release. Clin Biomech. 2003; 18:685-93.
Nunez F, Vranceanu AM, Ring D. Determinants of pain in patients with carpal tunnel syndrome. Clin Orthop Relat Res. 2010; 468:3328-32.
Seror P. Nerve conduction studies after treatment for carpal tunnel syndrome. J Hand Surg Br. 1992; 17:641-5.
Padua L, Padua R, Aprile I, Pasqualetti P, Tonali P, Italian CTS Study Group, et al. Multiperspective follow-up of untreated carpal tunnel syndrome: a multicenter study. Neurology. 2001; 56:1459-66.
Todnem K, Lundemo G. Median nerve recovery in carpal tunnel syndrome. Muscle Nerve. 2000; 23:1555-60.
Goodman HV, Gilliatt RW. The effect of treatment on median nerve conduction in patients with the carpal tunnel syndrome. Rheumatology. 1961; 6:137-55.
Hardoim DG, de Oliveira GB, Kouyoumdjian JA. Carpal tunnel syndrome: long-term nerve conduction studies in 261 hands. Arq Neuropsiquiatr. 2009; 67: 69-73.
Seror P. Sensitivity of the various tests for the diagnosis of carpal tunnel syndrome. J Hand Surg Br. 1994; 19:725-8.
Cioni R, Passero S, Paradiso C, Giannini F, Battistini N, Rushworth G. Diagnostic specificity of sensory and motor nerve conduction variables in early detection of carpal tunnel syndrome. J Neurol. 1989; 236:208-13.
Gerritsen AA, de Vet HC, Scholten RJ, Bertelsmann FW, de Krom MC, Bouter LM. Splinting vs surgery in the treatment of carpal tunnel syndrome: a randomized controlled trial. JAMA. 2002; 288:1245-51.
| ||
آمار تعداد مشاهده مقاله: 2,186 تعداد دریافت فایل اصل مقاله: 1,784 |