Demirci Serpil, Kutluhan Suleyman, Koyuncuoglu H Rifat, Kerman Memduh, Heybeli Nurettin, Akkuş Selami, Akhan Galip
Department of Neurology, Suleyman Demirel University School of Medicine, Isparta, Turkey.
Rheumatol Int. 2002 May;22(1):33-7. doi: 10.1007/s00296-002-0184-0.
To compare the efficacy of local steroid injection and open carpal tunnel release, a symptom and functional status questionnaire (Boston Questionnaire) and sensory and motor nerve conduction studies were performed in 90 patients with electrophysiologically proven idiopathic carpal tunnel syndrome, of whom 44 were treated surgically and 46 by two-dose steroid injection. Electrophysiologic studies and the Boston Questionnaire were applied before and at the 3rd and 6th months after treatment. Both groups showed significant improvement at first follow-up. The surgically treated group showed a significant and further improvement of symptoms and conduction values between the 3rd- and 6th-month evaluations, whereas no significant change was observed in the patient group treated by steroid injection. By the end of follow-up, 5% of the hands in the open carpal tunnel release (OCTR) group and 13% of the hands in the local steroid injection (LSIG) group showed electrophysiological worsening, and 5% of the hands in the OCTR group and 22% of the hands in the LSIG group showed symptomatic worsening. Our results show that steroid injection provides an improvement comparable with that from surgical release of the median nerve at a 3-month interval. However, this improvement is not long-lasting.
为比较局部注射类固醇与开放性腕管松解术的疗效，对90例经电生理证实为特发性腕管综合征的患者进行了症状和功能状态问卷调查（波士顿问卷）以及感觉和运动神经传导研究，其中44例接受手术治疗，46例接受两剂类固醇注射治疗。在治疗前以及治疗后的第3个月和第6个月进行电生理研究和波士顿问卷调查。两组在首次随访时均显示出显著改善。手术治疗组在第3个月和第6个月评估之间症状和传导值有显著且进一步的改善，而类固醇注射治疗的患者组未观察到显著变化。随访结束时，开放性腕管松解术（OCTR）组5%的手部和局部类固醇注射（LSIG）组13%的手部出现电生理恶化，OCTR组5%的手部和LSIG组22%的手部出现症状恶化。我们的结果表明，类固醇注射在3个月时提供的改善与正中神经手术松解相当。然而，这种改善并不持久。
