Yücetaş Seyho Cem, Yildirim Adem
Department of Neurosurgery, Adıyaman University Education and Research Hospital, Adıyaman, Turkey.
J Neurol Surg A Cent Eur Neurosurg. 2013 Nov;74(6):393-9. doi: 10.1055/s-0033-1342932. Epub 2013 Aug 8.
The purpose of our study was to compare the results of standard open and mini open (approximately 1.5-cm incision), KnifeLight instrument (Stryker Instruments, Kalamazoo, Michigan, USA) assisted carpal tunnel release (CTR) concerning symptomatic, functional, and electrophysiological aspects, as well as complications during early and late postoperative follow-up.
Seventy-five patients who did not improve with nonsurgical methods and were planned to undergo surgery were separated into two groups. Patients in the first group (n = 37) underwent surgery with standard open CTR (Group A); patients in the second group (n = 38) underwent surgery with mini open KnifeLight instrument assisted CTR (Group B). Preoperative and 6-month postoperative electrophysiological values and functional utilization of the operated hand of both groups were compared. Nerve conduction studies were used for electrophysiological evaluation, visual analog scale (VAS) was used for pain evaluation, symptom severity scale (SSS) was used for symptomatic evaluation, and functional status scale (FSS) was used to evaluate hand functions that are the part of the Boston Carpal Tunnel Questionnaire. All evaluations were done preoperatively and repeated at postoperative month 6. Also, to determine early effects of surgical procedures, SSS and FSS scales were repeated at postoperative week 2 and month 3. Groups were also compared for complications and need for reoperation.
No significant difference was detected between the two groups at postoperative month 6 on VAS and electrophysiological values. Postoperative week 2 FSS and SSS scores of Group B were significantly lower than Group A. Although scores were lower in Group B at month 3, there was no statistically significant difference. Six months after surgery, no significant difference was detected between the two groups in mean SSS and FSS scores. Postoperative complications and reoperation rates were lower in Group B but the difference was not statistically significant.
After 6 months the results of both techniques for CTR are comparable. Mini open KnifeLight instrument assisted CTR is easy to perform and is superior to standard open CTR in the early post-operative period.
本研究的目的是比较标准开放性和微型开放性（约1.5厘米切口）、KnifeLight仪器（美国密歇根州卡拉马祖的史赛克仪器公司）辅助腕管松解术（CTR）在症状、功能、电生理方面的结果，以及术后早期和晚期随访期间的并发症情况。
75例非手术治疗无效且计划接受手术的患者被分为两组。第一组（n = 37）患者接受标准开放性CTR手术（A组）；第二组（n = 38）患者接受微型开放性KnifeLight仪器辅助CTR手术（B组）。比较两组术前和术后6个月手术手的电生理值及功能使用情况。神经传导研究用于电生理评估，视觉模拟量表（VAS）用于疼痛评估，症状严重程度量表（SSS）用于症状评估，功能状态量表（FSS）用于评估作为波士顿腕管问卷一部分的手部功能。所有评估均在术前进行，并在术后第6个月重复进行。此外，为了确定手术操作的早期效果，SSS和FSS量表在术后第2周和第3个月重复进行。还比较了两组的并发症情况及再次手术的必要性。
术后第6个月，两组在VAS和电生理值方面未检测到显著差异。B组术后第2周的FSS和SSS评分显著低于A组。虽然B组在第3个月时评分较低，但无统计学显著差异。术后6个月，两组的平均SSS和FSS评分未检测到显著差异。B组术后并发症和再次手术率较低，但差异无统计学意义。
6个月后，两种CTR技术的结果具有可比性。微型开放性KnifeLight仪器辅助CTR操作简便，在术后早期优于标准开放性CTR。
