Morphologic Analysis of the Carpal Tunnel and Median Nerve Following Open and Endoscopic Carpal Tunnel Release
Autor: | Robert B. Turner, Blair R Peters, Brett Memauri, Amanda M. Martin, Kenneth A. Murray, Avinash Islur, Hardy W. Bock |
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Rok vydání: | 2019 |
Předmět: |
musculoskeletal diseases
medicine.medical_specialty Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine medicine Carpal tunnel release Humans Orthopedics and Sports Medicine Carpal tunnel Prospective Studies Carpal tunnel syndrome Surgery Articles medicine.diagnostic_test business.industry Significant difference Endoscopy Magnetic resonance imaging medicine.disease Carpal Tunnel Syndrome Median nerve Median Nerve Surgery Endoscopic carpal tunnel release body regions Dissection medicine.anatomical_structure 030220 oncology & carcinogenesis business 030217 neurology & neurosurgery |
Zdroj: | Hand (N Y) |
ISSN: | 1558-9455 1558-9447 |
Popis: | Background: Endoscopic carpal tunnel release (ECTR) has purported advantages over open release such as reduced intraoperative dissection and trauma and more rapid recovery. Endoscopic carpal tunnel release has been shown to have comparable outcomes to open release, but open release is considered easier and safer to perform. Previous studies have demonstrated an increase in carpal tunnel volume, regardless of the technique used. However, the mechanism by which this volumetric increase occurs has been debated. Our study will determine through magnetic resonance imaging (MRI) analysis the morphologic changes that occur in both open carpal tunnel release (OCTR) and ECTR, thereby clarifying any morphologic differences that occur as a result of the 2 operative techniques. We hypothesize that there will be no morphologic differences between the 2 techniques. Methods: This was a prospective study to compare the postoperative anatomy of both techniques with MRI. Nineteen patients with clinical and nerve conduction study–confirmed carpal tunnel syndrome underwent either open or endoscopic release. Magnetic resonance imaging was performed preoperatively and 6 months postoperatively in all patients to examine the volume of the carpal tunnel, transverse distance, anteroposterior (AP) distance, divergence of tendons, and Guyon’s canal transverse and AP distance. Results: There was no significant difference in the postoperative morphology of the carpal tunnel and median nerve between OCTR and ECTR at 6-month follow-up on MRI. Conclusion: We conclude that there are no morphologic differences in OCTR and ECTR. It is an increase in the AP dimension that appears to be responsible for the increase in the volume of the carpal tunnel. |
Databáze: | OpenAIRE |
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