Georgeto S M, Picharski G L, Andraus R A C, da Silva R A, Ngomo S, Fernandes K B P
Department of Neurosurgery, Irmandade da Santa Casa de Londrina, Londrina, PR; Doctoral Program in Rehabilitation Sciences UEL/UNOPAR, Universidade Pitágoras UNOPAR, Londrina, PR; Department of Surgery (Neurosurgery discipline), Universidade Estadual de Londrina (UEL), Londrina, PR.
Pelé Pequeno Príncipe Research Institute, Curitiba, PR.
J Plast Reconstr Aesthet Surg. 2022 Sep;75(9):3250-3259. doi: 10.1016/j.bjps.2022.06.070. Epub 2022 Jun 22.
Carpal tunnel syndrome (CTS) is the predominant compressive neuropathy among adults worldwide. However, evidence regarding treatment alternatives and their outcomes, especially with bilateral carpus involvement, is inconclusive. To analyze the clinical and surgical outcomes of bilateral CTS treatment using the visual analog scale (VAS) and Boston questionnaire, a systematic review was conducted according to PRISMA guidelines. After evaluating 129 articles from different databases, nine papers with low bias risk were included in the study. These studies were assessed for methodological quality, both in scale and degree, ensuring bias identification and independence of data extraction. Eligible articles were those in Portuguese, Spanish, and English, with no publication time limit. The outcomes assessed were the standardized mean differences (SMDs) on the symptom severity scale (SSS), functional state scale (FSS), and VAS. In the clinical treatment group, a positive effect was observed on the SSS (SMD: 0.53), FSS (SMD: 0.47), and VAS (SMD decrease: 2.52) at the one-month follow-up. In the surgical-treatment group, a positive effect was observed on the SSS (SMDs: 1.97 for endoscopic and 1.55 for open surgery), FSS (SMDs: 1.52 for endoscopic and 1.77 for open surgery), and VAS (SMDs: 2.19 for endoscopic and 2.59 for open surgery) at the one-month follow-up. Significant improvements in VAS, SSS, and FSS were observed at the three-month follow-up. Current evidence in both clinical and surgical treatments demonstrates their effectiveness, as they potentially improve symptom severity, functional status, and pain intensity in patients with bilateral CTS during one- and three-month follow-up periods.
腕管综合征（CTS）是全球成年人中最常见的压迫性神经病变。然而，关于治疗方案及其效果的证据，尤其是双侧腕部受累的情况，尚无定论。为了使用视觉模拟量表（VAS）和波士顿问卷分析双侧CTS治疗的临床和手术效果，我们根据PRISMA指南进行了一项系统评价。在评估了来自不同数据库的129篇文章后，9篇偏倚风险较低的论文被纳入研究。这些研究在规模和程度上都进行了方法学质量评估，以确保数据提取的偏倚识别和独立性。符合条件的文章为葡萄牙语、西班牙语和英语撰写，无发表时间限制。评估的结果是症状严重程度量表（SSS）、功能状态量表（FSS）和VAS上的标准化平均差（SMD）。在临床治疗组中，在1个月随访时，SSS（SMD：0.53）、FSS（SMD：0.47）和VAS（SMD降低：2.52）上观察到了积极效果。在手术治疗组中，在1个月随访时，SSS（内镜手术SMD：1.97，开放手术SMD：1.55）、FSS（内镜手术SMD：1.52，开放手术SMD：1.77）和VAS（内镜手术SMD：2.19，开放手术SMD：2.59）上观察到了积极效果。在3个月随访时，VAS、SSS和FSS有显著改善。目前临床和手术治疗的证据都证明了它们的有效性，因为它们在1个月和3个月的随访期内有可能改善双侧CTS患者的症状严重程度、功能状态和疼痛强度。
