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Abstract

Long-Term Treatment Outcomes after Diagnosed as Carpal Tunnel Syndrome by Electrodiagnosis

Somsud K, Boonhong J

Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University

Objectives: To report long-term outcomes in patients with CTS and to compare the outcomes between conservative and surgery treatments, after being diagnosed by nerve conduction study (NCS)

Study design: Retrospective descriptive study

Setting: Electrodiagnosis laboratory, King Chulalongkorn Memorial Hospital.

Method: Patients who were diagnosed with CTS by NCS and had more than one year follow-up were included into the study. Data including sex, age, underlying disease, treatment method, clinical improvement after treatments and NCS parameters were analyzed and compared between conservative treatment and surgery.

Results: There were 207 patients with mean age of 54.49 (SD 11.63) years, 88.9% females; 91.6% had bilateral CTS. Out of 382 hands, 71.5% were treated conservatively with vitamin (100%), non-steroidal anti-inflammatory drug (13.1%), splint (8.1%) and steroid injection (5.0%) whereas 28.5% were surgically treated. Baseline NCS grading as severe CTS was more in the surgery group (p < 0.001). After conservative treatment, 12.1% were cured, 56.0% improved, 27.3% not changed and 4.6% worse; whereas after surgery 32.0% were cured, 62.4% improved, 2.8% not changed and 2.8% worse. The surgical group had more improvement than the conservative group (p< 0.001). During follow up, 34.1% of the conservative and 14.7% of the surgical groups had NCS done. There were no significant difference in changes of NCS parameters between the two groups but reduction in CTS symptoms and severity was more in the surgical than conservative groups (45.8% VS 7.3%).

Conclusion: Majority of CTS was conservatively treated. Those with severe carpal tunnel syndrome diagnosed with nerve conduction studies had more tendency of surgery. Severity was reduced more after surgery than conservative treatments.