Carpal tunnel and median nerve volume changes after tunnel release in patients with the carpal tunnel syndrome: a magnetic resonance imaging (MRI) study

Purpose Our aim was to study the dynamics of the post-surgical canal and nerve volumes and their relationships to objective [electromyoneurography (EMNG)] and subjective (pain) outcomes. Methods Forty-seven patients with carpal tunnel syndrome (CTS) (median age 52, range 23-75 years) with a prominen...

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Bibliographic Details
Published in:International orthopaedics 2016-05, Vol.40 (5), p.981-987
Main Authors: Crnković, T., Trkulja, V., Bilić, R., Gašpar, D., Kolundžić, R.
Format: Article
Language:English
Subjects:
Adult
Aged
Carpal Tunnel Syndrome - surgery
Electromyography - methods
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging - methods
Male
Median Nerve - pathology
Median Nerve - surgery
Medicine
Medicine & Public Health
Middle Aged
Original Paper
Orthopedics
Pain - pathology
Young Adult
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Summary:Purpose Our aim was to study the dynamics of the post-surgical canal and nerve volumes and their relationships to objective [electromyoneurography (EMNG)] and subjective (pain) outcomes. Methods Forty-seven patients with carpal tunnel syndrome (CTS) (median age 52, range 23-75 years) with a prominent narrowing of the median nerve within the canal (observed during carpal tunnel release) were evaluated clinically using EMNG and magnetic resonance imagining (MRI) before and at 90 and 180 days post-surgery. Results Canal and nerve volumes increased, EMNG findings improved and pain resolved during the follow-up. Increase in tunnel volume was independently associated with increased nerve volume. A greater post-surgical nerve volume was independently associated with a more prominent resolution of pain, but not with the extent of EMNG improvement, whereas EMNG improvement was not associated with pain resolution. Conclusions Data confirm that MRI can detect even modest changes in the carpal tunnel and median nerve volume and that tunnel release results in tunnel and nerve-volume increases that are paralleled by EMNG and clinical improvements. Taken together, these observations suggest that MRI could be used to objectivise persistent post-surgical difficulties in CTS patients. Level of evidence 3 (follow-up study).
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-015-3052-8