Cho Yong-Jun, Cho Sung-Min, Sheen Seung-Hoon, Choi Jong-Hun, Huh Dong-Hwa, Song Joon-Ho
Department of Neurosurgery, Chunchon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea.
J Korean Neurosurg Soc. 2007 Nov;42(5):382-7. doi: 10.3340/jkns.2007.42.5.382. Epub 2007 Nov 20.
Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients.
According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less).
Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was 41.8+/-15.2 m/s and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment (57.8+/-6.9 m/s) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from 39.8+/-12.1 m/s to 47.8+/-12.1 m/s (p<0.05). After an average follow-up of 4.8+/-5.3 months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve.
Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.
肘管综合征是上肢第二常见的卡压性神经病变。尽管已引入多种不同的手术技术，但尚无一种被证明优于其他技术。单纯肘管减压具有诸多优点，包括操作简单和安全性高。我们介绍了对15例患者采用单纯减压治疗肘管综合征的经验。
根据戴伦标准，1例患者被分类为1级，8例为2级，6例为3级。所有患者均进行了术前电诊断研究，其中7例术后复查。15例患者中有5例采用小皮肤切口（2厘米或更小）进行单纯减压。
该节段（肘部上方 - 肘部下方）运动传导速度（MCV）术前平均值为41.8±15.2米/秒，与肘部下方 - 腕部节段的MCV结果（57.8±6.9米/秒）相比有所下降，具有统计学意义（p<0.05）。7例患者中有6例术后MCV平均值从39.8±12.1米/秒提高到47.8±12.1米/秒（p<0.05）。平均随访4.8±5.3个月后，根据改良的毕晓普评分系统，15例患者中有14例（93%）报告临床结果良好或优秀。采用小皮肤切口治疗的5例患者取得了良好或优秀的结果。未出现尺神经并发症、复发或半脱位。
对于肘管综合征患者，单纯尺神经减压是一种有效且成功的微创技术。
