Epstein N E, Epstein J A, Carras R
Department of Surgery, North Shore University Hospital, Manhasset, New York.
J Spinal Disord. 1989 Mar;2(1):36-42.
In six patients, operations for bilateral carpal tunnel syndromes (CTS) were performed or were about to be performed without the awareness of the presence of underlying cervical spondylo-stenosis. Only later, when symptoms of myeloradiculopathy were recognized, was the diagnosis confirmed and decompressive laminectomy performed. Because the symptoms of CTS may resemble or be masked and accentuated by the cervical disorder, patients with the presumed diagnosis of bilateral CTS should undergo appropriate critical neurologic, electrodiagnostic, and neuroradiologic (magnetic resonance imaging, computed tomography, myelo-computed tomography) assessment. If these guidelines are followed, the radiculopathy caused by cervical pathology will be appropriately recognized and treated, possibly averting the need for carpal tunnel decompression or modifying treatment.
在6例患者中,双侧腕管综合征(CTS)手术已经进行或即将进行,但当时并未意识到存在潜在的颈椎管狭窄。只是后来,当脊髓神经根病症状被识别出来时,诊断才得以确认,并进行了减压性椎板切除术。由于CTS的症状可能与颈椎疾病相似,或者被颈椎疾病掩盖和加重,因此,被推测诊断为双侧CTS的患者应接受适当的严格神经系统、电诊断和神经放射学(磁共振成像、计算机断层扫描、脊髓计算机断层扫描)评估。如果遵循这些指导原则,由颈椎病变引起的神经根病将得到适当的识别和治疗,可能避免腕管减压的需要或调整治疗方案。