Surgical Treatment of the Carpal Tunnel Syndrome with the Application of Endoscopic and Electrophysiological Monitoring

Abstract

Introduction. Carpal tunnel syndrome (CTS) is a variant of tunnel neuropathy, which develops as a result of compression of the median nerve by a hypertrophic flexor retinaculum. Surgical treatment consists in the dissection of the flexor retinaculum which leads to fast pain alleviation and termination of neurologic deficit progression. Objective. To evaluate effectiveness of the new surgical treatment of CTS with endoscopic and electrophysiological monitoring. Materials and methods. Outcomes of the surgical treatment with the new combined technique were evaluated in a group of 72 patients. To assess effectiveness, visual analogue scale (VAS) for pain, frequency of complications and relapses, length of in-hospital stay, and temporary disability were assessed. Results. We found a significant reduction in VAS pain score from 6 [3; 7] to 2 [1; 3] points within the first day following surgery along with improvement of the skin pain sensitivity from 3 [2; 4] to 2 [2; 3] points. No significant complications and relapses were registered (N = 0). The average period of hospitalization was 16 [12; 24] hours and the temporary incapacity for work was 7 [5; 12] days. Conclusions. The new surgical approach significantly reduces level of pain syndrome and sensory disturbances, allows to achieve sufficient decompression of the nerve with minimal risks of complications, and reduce duration of in-hospital stay and temporary disability.