Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, 030032, China.
Department of Orthopedics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China.
J Orthop Surg Res. 2023 Jul 18;18(1):511. doi: 10.1186/s13018-023-03927-x.
Carpal tunnel syndrome (CTS) is the most common type of median nerve entrapment neuropathy. This study aims to comparatively assess the effectiveness and clinical efficacy of modified transforaminal endoscopic minimally invasive incision of transverse carpal ligament against traditional open incision of transverse carpal ligament in the treatment of CTS.
The clinical data of 35 patients (57 wrists) with primary CTS treated in Shanxi Bethune Hospital, China, were retrospectively analyzed. The patients were divided into observation group (21 cases, 33 wrists) and control group (14 cases, 24 wrists), respectively, who underwent modified endoscopic minimally invasive incision of transverse carpal ligament and traditional open incision of transverse carpal ligament release. The Boston Carpal Tunnel Questionnaire (BCTQ) was assessed at for points: before the operation; 2 weeks; 1 month; and 3 months after operation. The BCTQ scores of the two groups were compared on all four points. The incidence of intraoperative and postoperative complication was used as the evaluation index. The study variables were comparatively assessed before and postoperation and also between the groups.
The BCTQ scores at 2 weeks, 1 month and 3 months after the operation were significantly lower than preoperative BCTQ scores (P < 0.005) for both the groups. There was no significant difference in BCTQ scores between the two groups at the four assessment points (P > 0.005). The scar size and wound healing time were significantly better with modified transforaminal endoscopic minimally invasive transverse carpal ligament incision.
The clinical effects of both modified transforaminal minimally invasive incision of transverse carpal ligament and traditional open incision of transverse carpal ligament are significant, while the treatment efficacy of modified transforaminal minimally invasive transverse carpal ligament incision is better in terms of operation time, wound size, postoperative scar size and incision healing time.
腕管综合征（CTS）是最常见的正中神经卡压性神经病。本研究旨在比较改良经椎间孔内窥镜下微创腕横韧带切开术与传统开放腕横韧带切开术治疗 CTS 的疗效和临床疗效。
回顾性分析中国山西白求恩医院收治的 35 例（57 腕）原发性 CTS 患者的临床资料。患者分为观察组（21 例，33 腕）和对照组（14 例，24 腕），分别行改良内镜下微创腕横韧带切开术和传统开放腕横韧带切开松解术。采用波士顿腕管问卷（BCTQ）评估：术前、术后 2 周、1 个月和 3 个月。比较两组 4 个时间点 BCTQ 评分。以术中及术后并发症发生率作为评价指标。比较术前和术后的研究变量，以及组间比较。
两组术后 2 周、1 个月、3 个月的 BCTQ 评分均明显低于术前（P<0.005）。两组在 4 个评估点的 BCTQ 评分无统计学差异（P>0.005）。改良经椎间孔内窥镜下微创腕横韧带切开术的疤痕大小和伤口愈合时间明显更好。
改良经椎间孔内窥镜下微创腕横韧带切开术和传统开放腕横韧带切开术的临床效果均显著，而改良经椎间孔内窥镜下微创腕横韧带切开术在手术时间、伤口大小、术后疤痕大小和切口愈合时间方面的治疗效果更好。
