Keiner Doerthe, Gaab Michael R, Schroeder Henry W S, Oertel Joachim
Department of Neurosurgery, Hannover Nordstadt Hospital, Affiliated Hospital Hannover Medical School, Hannover, Germany.
Neurosurgery. 2009 Jan;64(1):131-7; discussion 137-8. doi: 10.1227/01.NEU.0000335784.90217.9D.
The long-term efficacy of dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is still being debated. In this study, the authors present 94 endoscopic carpal tunnel surgery cases with long-term follow-up data.
The study includes 72 patients aged 17 to 86 years (mean age, 53.4 years); bilateral surgery was performed in 22 of these patients. Seventy-two hands of female patients and 22 hands of male patients were included. All procedures were performed with a dual-portal set according to the Chow technique. All patients were examined 2 to 3 months after surgery. The long-term follow-up evaluation was based on telephone interviews 5 to 12 years (mean, 8.2 years) after surgery.
From a cohort of 214 cases that were treated surgically between 1995 and 2002, 94 cases (44%) could be evaluated for long-term follow-up. Four of these patients had to be excluded from long-term follow-up because of a switch to an open technique and early open revision (3-6 months after the first surgery), owing to persistent symptoms. A good to optimal postoperative outcome with improvement of neurological signs and subjective patient satisfaction was observed in 84 (93.3%) of the remaining 90 cases. There were no recurrences.
The study shows that dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is a valuable technique that produces very good long-term results and high patient satisfaction and does not result in a significant recurrence rate.
腕管综合征中双切口内镜下横韧带松解术的长期疗效仍存在争议。在本研究中,作者呈现了94例接受内镜下腕管手术并具有长期随访数据的病例。
该研究纳入了72例年龄在17至86岁之间(平均年龄53.4岁)的患者;其中22例患者接受了双侧手术。纳入了72例女性患者的手和22例男性患者的手。所有手术均根据Chow技术使用双切口器械套装进行。所有患者在术后2至3个月接受检查。长期随访评估基于术后5至12年(平均8.2年)的电话访谈。
在1995年至2002年间接受手术治疗的214例患者队列中,94例(44%)可进行长期随访。其中4例患者因术后持续症状而改用开放手术技术并早期进行开放翻修(首次手术后3至6个月),被排除在长期随访之外。在其余90例患者中的84例(93.3%)观察到术后效果良好至最佳,神经体征改善且患者主观满意度高。无复发情况。
该研究表明,腕管综合征中双切口内镜下横韧带松解术是一项有价值的技术,可产生非常好的长期效果和较高的患者满意度,且复发率不高。