Keiner Dörthe, Gaab Michael R, Schroeder Henry W S, Oertel Joachim
Department of Neurosurgery, Universitaetsklinikum, Johannes Gutenberg Universität, Mainz, Germany.
Acta Neurochir (Wien). 2009 Apr;151(4):311-5; discussion 316. doi: 10.1007/s00701-009-0218-4. Epub 2009 Mar 7.
In order to assess their late benefits we present the long-term results of a comparison of treating cubital tunnel syndrome with anterior submuscular transposition or simple decompression.
Of 40 patients initially recruited to this study 33 were available for long term follow-up. Sixteen patients underwent anterior submuscular transposition (group A); simple decompression was performed in 17 of the patients (group B). The indications for inclusion were a typical clinical presentation confirmed by abnormal nerve conduction studies. The mean duration of the symptoms before operation was 13 months (range 2 to 84 months) in group A and 8.4 months (range 1.5 to 36 months) in group B. All patients were seen 2 months after surgery and at least 3 years later. The mean duration of follow-up was 63.1 month in the first group and 52 months in the second group.
No complications were seen in either group. In the group treated by anterior transposition, ten of 16 patients were completely free of signs and symptoms; slight residual hypesthesia or paresthesia was observed in two patients. Paresis and atrophy was observed in only one person. In the simple decompression group, 11 of 17 patients were completely free of signs and symptoms. In five patients slight residual symptoms were observed; no paresis or atrophy was reported in any of this group.
These long-term results show that both surgical techniques have a good outcome. Thus, the less invasive simple decompression should be preferred.
为了评估其远期疗效，我们展示了一项比较采用肌下前置术或单纯减压术治疗肘管综合征的长期结果。
最初招募到本研究的40例患者中，33例可供长期随访。16例患者接受了肌下前置术（A组）；17例患者进行了单纯减压术（B组）。纳入标准为典型临床表现并经异常神经传导研究证实。A组术前症状平均持续时间为13个月（范围2至84个月），B组为8.4个月（范围1.5至36个月）。所有患者均在术后2个月及至少3年后接受检查。第一组平均随访时间为63.1个月，第二组为�2个月。
两组均未出现并发症。在肌下前置术治疗组中，16例患者中有10例完全没有体征和症状；2例患者有轻微残留感觉减退或感觉异常。仅1例患者出现轻瘫和萎缩。在单纯减压组中，17例患者中有11例完全没有体征和症状。5例患者有轻微残留症状；该组未报告有轻瘫或萎缩病例。
这些长期结果表明，两种手术技术都有良好的疗效。因此，应首选侵入性较小的单纯减压术。
