脊髓损伤退伍军人的腕管松解术是否未得到充分利用？
Is carpal tunnel release under-utilized in veterans with spinal cord injury?
作者信息
Barr Cameron, Suarez Paola, Ota Doug, Curtin Catherine M
机构信息
Stanford University School of Medicine, Stanford, CA, USA.
出版信息
J Spinal Cord Med. 2011 Nov;34(6):563-8. doi: 10.1179/2045772311Y.0000000031.
OBJECTIVE
Carpal tunnel syndrome (CTS) is a common disorder among individuals with spinal cord injury (SCI). Although carpal tunnel release is highly effective, the procedure may be under-utilized in this population. This study attempts to identify if CTS is under-treated in Veterans with SCI.
DESIGN
The Veterans Affairs (VA) National Patient Care Database was used for data compilation within fiscal years 2007 and 2008. Using ICD-9-CM diagnoses codes, individuals with SCIs were identified, including those diagnosed with CTS. Current procedural terminology (CPT) codes further showed those who had undergone surgical intervention including open and endoscopic release of the transverse carpal ligament. The VA SCI cohort was compared to the general VA population with regard to demographics, diagnosis, surgical intervention, and treatment location.
RESULTS
A total of 19 296 veterans with SCI were identified within the 2-year period. The prevalence of CTS within this cohort was 3.5%, compared to 2.1% in the general VA population. The rate of transverse carpal ligament release was similar between the VA SCI cohort and general population (0.24 and 0.17%, respectively). The majority of surgical treatment (89%) occurred within the VA 'hub-and-spoke' system of SCI care.
CONCLUSION
CTS appears to be under-diagnosed and under-treated in veterans with SCI.
目的
腕管综合征（CTS）是脊髓损伤（SCI）患者中常见的疾病。尽管腕管松解术非常有效，但该手术在这一人群中的应用可能不足。本研究试图确定SCI退伍军人中CTS是否未得到充分治疗。
设计
使用退伍军人事务部（VA）国家患者护理数据库收集2007财年和2008财年内的数据。利用国际疾病分类第九版临床修订本（ICD-9-CM）诊断代码识别SCI患者，包括那些被诊断为CTS的患者。当前程序术语（CPT）代码进一步显示了那些接受过手术干预的患者，包括开放性和内镜下腕横韧带松解术。将VA SCI队列与一般VA人群在人口统计学、诊断、手术干预和治疗地点方面进行比较。
结果
在2年期间共识别出19296名SCI退伍军人。该队列中CTS的患病率为3.5%，而一般VA人群中为2.1%。VA SCI队列和一般人群中腕横韧带松解率相似（分别为0.24%和0.17%）。大多数手术治疗（89%）发生在VA的SCI护理“中心-辐条”系统内。
结论
SCI退伍军人中CTS似乎诊断不足且治疗不足。
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