Alsaleh Mutaz, Abishek Joshua, Basha Amr, Selmi Hussain, Al-Azzawi Mohammed, Makki Daoud
Trauma and Orthopaedics, Watford General Hospital, West Hertfordshire Teaching Hospitals NHS Trust, Watford, GBR.
Trauma and Orthopaedics, NHS Tayside, Dundee, GBR.
Cureus. 2024 Nov 16;16(11):e73827. doi: 10.7759/cureus.73827. eCollection 2024 Nov.
Background and objective Hand numbness, often associated with carpal tunnel syndrome (CTS) and cubital tunnel syndrome (CuTS), significantly impacts the quality of life. This study aimed to evaluate the effectiveness of combined carpal and cubital tunnel decompression (CCTD) in patients with concurrent mild to moderate cervical spine stenosis when compared to single decompression procedures. Methods We retrospectively reviewed the records of 100 patients who underwent decompression surgery for hand numbness and concurrent cervical spine stenosis, with positive electromyography (EMG) results in some cases, between January 1, 2023, and January 1, 2024. Surgical interventions included carpal tunnel decompression (CTD, n=91), cubital tunnel decompression (CuTD, n=4), and combined procedures (n=5). Results Of the 100 patients (aged range: 32-92 years), 11 with coexisting cervical stenosis reported neck pain. Those who underwent CCTD reported significantly lower pain severity and interference scores, as well as better functional outcomes, compared to single decompression groups. Despite the small number of patients (n=5) in the combined decompression group, preliminary findings suggest potential benefits related to this approach. Conclusions Simultaneous decompression of the carpal and cubital tunnels may offer superior symptom relief and functional improvement in patients with mild to moderate cervical spine stenosis, highlighting the importance of addressing cervical spine pathology in cases of hand numbness. However, further research with larger sample sizes is warranted to validate these preliminary results and better understand the efficacy of combined decompression for complex cases.
背景与目的 手部麻木常与腕管综合征（CTS）和肘管综合征（CuTS）相关，严重影响生活质量。本研究旨在评估与单一减压手术相比，联合腕管和肘管减压（CCTD）治疗合并轻至中度颈椎管狭窄患者的有效性。方法 我们回顾性分析了2023年1月1日至2024年1月1日期间100例行手部麻木减压手术且合并颈椎管狭窄、部分病例肌电图（EMG）结果为阳性的患者记录。手术干预包括腕管减压（CTD，n = 91）、肘管减压（CuTD，n = 4）和联合手术（n = 5）。结果 在100例患者（年龄范围：32 - 92岁）中，11例合并颈椎管狭窄的患者报告有颈部疼痛。与单一减压组相比，接受CCTD的患者报告的疼痛严重程度和干扰评分显著更低，功能结局也更好。尽管联合减压组患者数量较少（n = 5），但初步结果表明该方法有潜在益处。结论 同时对腕管和肘管进行减压可能为轻至中度颈椎管狭窄患者提供更好的症状缓解和功能改善，突出了在手部麻木病例中处理颈椎病变的重要性。然而，需要进一步开展更大样本量的研究来验证这些初步结果，并更好地了解联合减压对复杂病例的疗效。
