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内镜下尺神经沟松解术后至少1年随访的患者报告结局指标

Patient-Reported Outcome Measures After Endoscopic Cubital Tunnel Release With At Least 1-Year Postoperative Follow-up.

作者信息

Shekouhi Ramin, Chughtai Morad, Benjamin Jonathan A, Saengchote Supreeya A, Chim Harvey

机构信息

University of Florida, Gainesville, USA.

出版信息

Hand (N Y). 2025 Mar;20(2):170-178. doi: 10.1177/15589447231199798. Epub 2023 Sep 27.

Abstract

BACKGROUND

The primary objective of this study was to investigate midterm outcomes following endoscopic cubital tunnel release (ECuTR) with the Seg-Way system using patient-reported outcome measures (PROMs). A secondary aim was to evaluate symptom resolution as assessed through Dellon's stage, McGowan's grade, and Messina's criteria and recurrence following ECuTR.

METHODS

Functional outcomes were assessed in 38 patients who underwent 43 surgeries. Details on baseline characteristics as well as preoperative and postoperative symptoms were collected. Patient-reported outcome measures were administered with at least 1-year follow-up in all patients.

RESULTS

Mean age of patients was 50.2 ± 16.1 years, with 20 men (52.6%) and 18 women (47.4%). Postoperatively, pain completely resolved in 21 (72.4%), while sensory and motor deficits improved completely in 22 (56.4%) and 11 (64.7%) patients, respectively. Mean time interval between ECuTR and PROMs was 26.3 (13-63) months. Median Michigan Hand Outcomes Questionnaire score was 73.2 (48-91). Median Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale (NRS) scores were 12.9 (7-35) and 2.5 (0-5), respectively. Most of the patients were satisfied postoperatively with a median satisfaction score of 4 (3-5). There was a significant difference in median DASH and NRS scores between patients with and without concomitant proximal nerve disease.

CONCLUSION

Endoscopic cubital tunnel release is a safe and effective option for surgical management of primary cubital tunnel syndrome. The presence of other proximal nerve disease is associated with poorer outcomes, less symptom resolution, and higher recurrence rates. One-year postoperative PROMs show equivalence to those reported in other studies following open cubital tunnel release.

摘要

背景

本研究的主要目的是使用患者报告结局指标(PROMs)来调查采用Seg-Way系统进行内镜下尺神经沟松解术(ECuTR)后的中期结局。次要目的是通过戴伦分期、麦高恩分级和梅西纳标准评估症状缓解情况以及ECuTR后的复发情况。

方法

对38例接受了43次手术的患者的功能结局进行评估。收集了基线特征以及术前和术后症状的详细信息。所有患者均进行了至少1年的随访并采用患者报告结局指标。

结果

患者的平均年龄为50.2±16.1岁,其中男性20例(52.6%),女性18例(47.4%)。术后,21例(72.4%)患者疼痛完全缓解,而22例(56.4%)感觉功能障碍患者和11例(64.7%)运动功能障碍患者的症状分别完全改善。ECuTR与PROMs之间的平均时间间隔为26.3(13 - 63)个月。密歇根手部结局问卷的中位数得分为73.2(48 - 91)。手臂、肩部和手部功能障碍(DASH)和数字评定量表(NRS)的中位数得分分别为12.9(7 - 35)和2.5(0 - 5)。大多数患者术后感到满意,满意度中位数为4(3 - 5)。伴有和不伴有近端神经疾病的患者在DASH和NRS中位数得分上存在显著差异。

结论

内镜下尺神经沟松解术是原发性尺神经沟综合征手术治疗的一种安全有效的选择。其他近端神经疾病的存在与较差的结局、较少的症状缓解和较高的复发率相关。术后1年的PROMs显示与其他开放性尺神经沟松解术后研究报告的结果相当。

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本文引用的文献

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