Surgical treatment of the carpal tunnel syndrome using endoscopic and electrophysiological monitoring

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 implies 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 using 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, VAS, frequency of complications and relapses, length of inpatient hospitalization, 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 surface pain sensitivity from 3 [2; 4] to 2 [2; 3] points. No significant complications of relapses were found (N = 0). The average period of inpatient 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 hospitalization and temporary disability.