Iranian Journal of Neurosurgery
مجله جراحی مغز و اعصاب ایران
Iran J Neurosurg
Medical Sciences
http://irjns.org
1
admin
2423-6497
2423-6829
10.32598/irjns
en
jalali
1398
10
1
gregorian
2020
1
1
6
1
online
1
fulltext
en
Revisiting the Urge to Operate: One-year Neurophysiological Follow-up in Severe CTS
Peripheral nervous system
Research
<div style="text-align: justify;"><strong>Background and Aim: </strong>Several approaches have been proposed for the treatment of Carpal Tunnel Syndrome (CTS) based on its severity. The aim of this study is to determine the optimal management for severe CTS.<br>
<strong>Methods and Materials/Patients: </strong>This cross-sectional study was conducted for 22 months from August 2017 to June 2019 in a referral rehabilitation clinic in southern Iran. A total of 117 hands diagnosed with severe CTS were included in 78 patients according to Electrodiagnostic Study (EDX) reports (considering Sensory Proximal Latency (SPL) >3.6 msec, Sensory Distal Latency (SDL) >5.3 msec, Sensory Nerve Conduction Velocity (SNCV) <30 m/sec, Distal Motor Latency (DML) >6.5 msec as being severe) who refused to undergo surgery. Boston questionnaire was filled out and conventional EDX was carried out at the first and the 1-year follow-up visits.<br>
<strong>Results: </strong>In patients with a detectable Sensory Nerve Action Potential (SNAP), motor amplitude (P<0.002) and latency (P<0.01), SPL (P<0.003) and SNCV (P<0.006), and Boston parameters improved significantly in the one-year follow-up visit compared with the results at the first visit. However, improvement in patients with absent or low amplitude SNAP at the first visit was only observed in proximal sensory latency (P<0.005) and amplitude (P<0.003).<br>
<strong>Conclusion: </strong>There is a considerable chance for non-surgical improvement of patients with severe CTS in terms of symptom relief, hand function, and EDX parameters in those with detectable SNAP at the first visit; however, patients with undetectable SNAP have little, if any, the chance for improvement with<br>
conservative measures.</div>
Electrodiagnosis, Carpal
tunnel syndrome, Boston
questionnaire, Conservative
treatment, Sensory Nerve
Action
21
28
http://irjns.org/browse.php?a_code=A-10-214-3&slc_lang=en&sid=1
Alireza
Ashraf
10031947532846005178
10031947532846005178
No
MD., Professor, Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
Zahra
Hooshanginezhad
10031947532846005179
10031947532846005179
No
MD., Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Attiyeh
Vasaghi
10031947532846005180
10031947532846005180
No
MD., Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Shiraz, Iran.
Nima
Derakhshan
10031947532846005181
10031947532846005181
Yes
Assistant Professor, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.