Aksekili Mehmet Atıf Erol, Biçici Vedat, Işık Çetin, Aksekili Hatice, Uğurlu Mahmut, Doğan Metin
Department of Orthopedics, Yildirim Beyazit University School of Medicine Ankara, Turkey.
Atatürk Training and Research Hospital, Orthopeady and Traumatology Ankara, Turkey.
Int J Clin Exp Med. 2015 Apr 15;8(4):6267-71. eCollection 2015.
In this study, we aimed to compare the clinical findings and ENMG results of the patients who underwent surgery due to CTS, in the preoperative and early postoperative period.
33 wrists of 29 patients who underwent open carpal tunnel surgery in our clinic due to CTS, between 2009 and 2011, were evaluated. Electrophysiological progress was evaluated with ENMG and clinical state with Boston scale.
A significant decrease was observed in the postoperative BS symptomatic (SSS) and functional (FSS) scores of patients as compared to preoperative period (P=0.00). In the electrophysiological findings, statistically significant improvement was observed in all groups but very severe CTS group (P<0.05). When preoperative and postoperative EMG findings were compared, changes in DSL and DSA values were statistically significant (P<0.05). However, no statistically significant difference was seen between DML (P=0.085) and DMA (P=246) values on the 3rd month. When an examination was conducted on the patients whose DML and DSL values could not be obtained in the preoperative EMG, DML values were obtained in the early postoperative period in 6 of 7 cases (85.71%, P<0.001), and DSL values were obtained in 17 of 24 cases (70.8%, P<0.000).
Sensory nerve findings were more significant, showed faster recovery compared to motor nerve findings, and accompanied the clinical recovery. Performance of an EMG test, especially on sensory nerves, will be more effective in patients selected in the early period, with the exception of patients with very severe CTS.
在本研究中,我们旨在比较因腕管综合征(CTS)接受手术的患者在术前和术后早期的临床发现及神经电生理检查(ENMG)结果。
对2009年至2011年间在我们诊所因CTS接受开放性腕管手术的29例患者的33只手腕进行了评估。通过ENMG评估电生理进展,并用波士顿量表评估临床状态。
与术前相比,患者术后的波士顿量表症状性(SSS)和功能性(FSS)评分显著降低(P = 0.00)。在电生理检查结果中,除非常严重的CTS组外,所有组均观察到有统计学意义的改善(P < 0.05)。比较术前和术后的肌电图(EMG)结果时,感觉神经潜伏期(DSL)和感觉神经动作电位波幅(DSA)值的变化具有统计学意义(P < 0.05)。然而,在术后第3个月时,运动神经传导潜伏期(DML,P = 0.085)和运动神经动作电位波幅(DMA,P = 0.246)值之间未观察到统计学意义上的差异。对术前EMG中无法获得DML和DSL值的患者进行检查时,7例中有6例(85.71%,P < 0.001)在术后早期获得了DML值,24例中有17例(70.8%,P < 0.000)获得了DSL值。
感觉神经的检查结果更显著,与运动神经检查结果相比恢复更快,并与临床恢复同步。进行EMG检查,尤其是对感觉神经进行检查时,对于早期选择的患者(非常严重的CTS患者除外)将更有效。