Ultrasound-Guided Modified Thread Carpal Tunnel Release for Carpal Tunnel Syndrome: A Pilot Study

Abstract

Purpose This study aimed to investigate the effectiveness and safety of modified thread carpal tunnel release (mTCTR) using Smartwire-01 in patients with carpal tunnel syndrome (CTS).

Materials and Methods Patients with CTS who required CTR were enrolled. Symptom severity and functional status were assessed using the Boston Carpal Tunnel Syndrome Questionnaire-Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), and pain was assessed using a numerical rating scale (NRS) at 4, 8, and 12 weeks after mTCTR. The scores were compared with the pre-procedural scores. The electrophysiologic study and median nerve cross-sectional area (CSA) measurements at the wrist before and 12 weeks after mTCTR were compared.

Results A total of 11 patients were included. No adverse effects were reported throughout the study period. The NRS, BCTQ-SSS, and BCTQ-FSS scores significantly improved at 4 weeks after mTCTR, and this improvement persisted throughout the follow-up period (NRS and BCTQ-SSS, P < 0.001; BCTQ-FSS, P = 0.012). After 12 weeks, the latency and velocity of the median sensory nerve action potential significantly improved, compared with those before mTCTR (latency, 5.4 ± 1.3 to 4.7 ± 1.1 ms, P = 0.01; velocity 27.8 ± 6.8 to 31.8 ± 7.4 m/s, P = 0.019). No significant change was observed in the median nerve CSA before and after mTCTR.

Conclusion mTCTR using Smartwire-01 is a safe and effective procedure and a possible alternative to surgery.

Zusammenfassung

Ziel Ziel dieser Studie war es, die Wirksamkeit und Sicherheit des modifizierten Thread-Carpal-Tunnel-Release (mTCTR) bei Patienten mit Karpaltunnel-Syndrom (KTS) unter Verwendung von Smartwire-01 zu untersuchen.

Material und Methoden Patienten mit KTS, die CTR benötigten, wurden eingeschlossen. Der Schweregrad der Symptome und der funktionelle Status wurden mit dem „Boston Carpal Tunnel Syndrome Questionnaire“ mittels Symptom-Severity-Scale (BCTQ-SSS) und Functional-Status-Scale (BCTQ-FSS) beurteilt. Die Schmerzen wurden 4, 8 und 12 Wochen nach dem mTCTR durch die numerische Bewertungsskala (NRS) beurteilt. Die Werte wurden mit denen vor dem Eingriff verglichen. Die elektrophysiologische Untersuchung und die Messungen der Querschnittsfläche des N. medianus (CSA, cross-sectional area) am Handgelenk vor mTCTR und 12 Wochen danach wurden verglichen.

Ergebnisse Es wurden insgesamt 11 Patienten eingeschlossen. Während des gesamten Studienzeitraums wurden keine Nebenwirkungen gemeldet. Die NRS-, BCTQ-SSS- und BCTQ-FSS-Scores verbesserten sich 4 Wochen nach mTCTR signifikant, und diese Verbesserung hielt während des gesamten Nachbeobachtungszeitraums an (NRS und BCTQ-SSS, p<0,001; BCTQ-FSS, p=0,012). Nach 12 Wochen verbesserten sich Latenz und Geschwindigkeit des Aktionspotenzials des N. medianus im Vergleich zu den Werten vor mTCTR signifikant (Latenz 5,4 ± 1,3 auf 4,7 ± 1,1 ms, p=0,01; Geschwindigkeit 27,8 ± 6,8 auf 31,8 ± 7,4 m/s, p=0,019). Vor und nach mTCTR wurde keine signifikante Veränderung des CSA des N. medianus beobachtet.

Schlussfolgerung Der mTCTR mit Smartwire-01 ist ein sicheres und wirksames Verfahren und eine mögliche Alternative zur Operation.

Keywords

carpal tunnel syndrome - thread carpal tunnel release - ultrasound-guided procedure - median neuropathy

Publication History

Received: 05 October 2023

Accepted after revision: 21 February 2024

Article published online:
25 April 2024

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