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通过 3D 计算机断层扫描在肘管综合征手术治疗中的决策:手术技术和结果。

Decision Making via 3D Computed Tomography in the Surgical Treatment of Cubital Tunnel Syndrome: Surgical Technique and Results.

机构信息

Medipol University School of Medicine, Department of Neurosurgery, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2022;32(5):727-731. doi: 10.5137/1019-5149.JTN.35061-21.3.

Abstract

AIM

To investigate the importance of elbow 3D computed tomography in surgical planning when deciding on the treatment surgical treatment method of the ulnar nerve entrapment in the cubital tunnel.

MATERIAL AND METHODS

In this study, 21 patients with cubital tunnel syndrome in our clinic were included and retrospectively analyzed. All of the patients were diagnosed with EMG, and surgical planning was performed based on the anatomy of the cubital tunnel diagnosed via 3D computed tomography. In addition to the classical simple decompression of the ulnar nerve, 15 patients underwent cubital tunnel reconstruction with high-speed drill, whereas 6 patients underwent ulnar nerve anterior subcutaneous transposition. The results were evaluated based on the modified Wilson & Krout criteria.

RESULTS

Fourteen of the patients were female and seven were male. The average age was 42.2 years. Fifteen patients underwent simple decompression of the ulnar nerve and cubital tunnel reconstruction. Transposition was performed in six patients. The patients were followed up for an average of 107.5 months (3-144). Based on the Wilson & Krout criteria, excellent results were obtained in 14 patients (66.7%), good results in 6 (28.6%), and poor results in 1 (4.8%).

CONCLUSION

The evaluation of the cubital tunnel via 3D computed tomography before the operation is effective in determining the optimal surgical technique and obtaining more successful clinical results. The cubital tunnel reconstruction in addition to simple decompression increases surgical success and minimizes complications and the possibility of relapse due to the fact that the nerve remains in its natural position.

摘要

目的

探讨肘部 3D 计算机断层扫描在尺神经卡压肘管综合征治疗方法选择中的重要性。

材料与方法

回顾性分析 21 例我院肘管综合征患者,所有患者均行 EMG 检查,根据 3D 计算机断层扫描对肘管的解剖学诊断进行手术规划。除了经典的单纯尺神经减压外,15 例患者采用高速钻进行肘管重建,6 例患者行尺神经前皮下转位。根据改良 Wilson & Krout 标准进行评估。

结果

14 例为女性,7 例为男性;平均年龄为 42.2 岁。15 例患者行单纯尺神经减压和肘管重建,6 例行尺神经前皮下转位。平均随访 107.5 个月(3-144)。根据 Wilson & Krout 标准,14 例(66.7%)疗效优,6 例(28.6%)良,1 例(4.8%)差。

结论

术前对肘管进行 3D 计算机断层扫描评估有助于确定最佳手术技术,获得更成功的临床结果。除了单纯减压外,肘管重建可增加手术成功率,减少并发症和复发的可能性,因为神经保持在其自然位置。

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