Aslani Hamidreza, Zafarani Zohreh, Najafi Arvin, Alizadeh Khalil, Farjad Reza, Ghahremani Saman, Mosavvari Masoud, Lahiji Farivar Abdollahzadeh
Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tehran University of Medical Sciences, Tehran, Iran.
Clin Neurol Neurosurg. 2014 May;120:96-8. doi: 10.1016/j.clineuro.2014.02.025. Epub 2014 Mar 7.
The objective of this study is to evaluate the carpal canal morphologic consequences following endoscopic carpal tunnel release compared with open approach.
48 Patients with CTS were enrolled in our prospective trial. Participants were classified in 2 groups: 24 patients underwent open surgery technique and 24 underwent endoscopic carpal tunnel decompression. Carpal canal shape and volume, configuration and position of contents, were analyzed by using imaging techniques.
Preoperative carpal canal volume in endoscopic patient group averaged 5.7±1.4 cc and 7.3±2.9 cc at 6 weeks postoperatively (28%±7%, p=0.018). In contrast preoperative carpal canal volume in open carpal tunnel release group averaged 4.9±1.1 cc (and increased to 6.2±1.7 cc at 6-week follow up investigation (36%±5%, p=0.002). Preoperative carpal arch width calculation in endoscopic carpal tunnel release group averaged 21.7±1.1mm and 21.5±1.9mm in open carpal tunnel release patients (p=0.6575). Postoperative carpal arch width measurements in endoscopic carpal tunnel decompression group averaged 22.6±4.1mm and 22.1±2.9mm in open carpal tunnel release patient population at 6-week follow-up investigation (p=0.628).
Endoscopic approach causes an increment in carpal canal volume comparable to open technique and provides equivalent anatomic outcomes and will produce at least equivalent long-term clinical relief.
本研究的目的是评估与开放手术相比，内镜下腕管松解术后腕管的形态学变化。
48例腕管综合征患者纳入我们的前瞻性试验。参与者分为两组：24例患者接受开放手术技术，24例接受内镜下腕管减压术。使用成像技术分析腕管的形状和容积、内容物的形态和位置。
内镜手术患者组术前腕管容积平均为5.7±1.4立方厘米，术后6周为7.3±2.9立方厘米（增加28%±7%，p=0.018）。相比之下，开放腕管松解术组术前腕管容积平均为4.9±1.1立方厘米（6周随访时增加到6.2±1.7立方厘米，增加36%±5%，p=0.002）。内镜下腕管松解术组术前腕弓宽度平均为21.7±1.1毫米，开放腕管松解术患者为21.5±1.9毫米（p=0.6575）。内镜下腕管减压组术后6周腕弓宽度测量值平均为22.6±4.1毫米，开放腕管松解术患者组为22.1±2.9毫米（p=0.628）。
内镜手术导致腕管容积增加，与开放技术相当，提供了等效的解剖学结果，并且至少能产生等效的长期临床缓解效果。
