Frenkel Rutenberg Tal, Godny Lihi, Rutenberg Ran, Kadar Assaf, Frishman Sigal, Iordache Sorin Daniel
Department of Orthopedics, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Int J Obes (Lond). 2025 Jun;49(6):1051-1055. doi: 10.1038/s41366-025-01733-5. Epub 2025 Feb 27.
Obesity is related with increased risk for carpal tunnel syndrome (CTS). The effect of bariatric surgery (BS) on the incidence of nerve entrapments is undetermined. We aimed to evaluate the incidence of CTS following BS in a large cohort study.
A retrospective cohort study of patients with obesity who underwent BS was conducted. The incidence of CTS in the 5-years pre- and post BS was compared. Patients who developed CTS following BS were compared to those who did not.
Six-thousand, one-hundred and twenty-four patients met the inclusion criteria. The average age was 41.2 (SD 12.9) years, most were female (68.6%). The average pre-operative BMI was 42.9 (SD 5.4). Most patients underwent restrictive surgery. The incidence of CTS at the 5-years prior to the BS was significantly higher than the post BS incidence, 8.4% versus 5.1% respectively (p < 0.001) despite the aging of the cohort. Patients who developed CTS following the BS were older and had a higher prevalence of hypertension and diabetes mellitus prior to the BS. They had a higher BMI and excess body weight at every time point measured and a lower BMI reduction. Weight regain was not associated with increased incidence of CTS. Finally, a direct correlation between excess weight loss to greater reduction in the incidence of CTS was noted.
BS was found to be associated with reduced incidence of developing CTS. There is a dose-response association where greater weight loss following BS is protective of developing CTS.
肥胖与腕管综合征(CTS)风险增加相关。减肥手术(BS)对神经卡压发病率的影响尚不确定。我们旨在通过一项大型队列研究评估减肥手术后CTS的发病率。
对接受减肥手术的肥胖患者进行回顾性队列研究。比较减肥手术前5年和后5年CTS的发病率。将减肥手术后发生CTS 的患者与未发生CTS的患者进行比较。
6124例患者符合纳入标准。平均年龄为41.2(标准差12.9)岁,大多数为女性(68.6%)。术前平均体重指数(BMI)为42.9(标准差5.4)。大多数患者接受了限制性手术。尽管队列中有老龄化情况,但减肥手术前5年CTS的发病率仍显著高于减肥手术后的发病率,分别为8.4%和5.1%(p < 0.001)。减肥手术后发生CTS的患者年龄更大,减肥手术前高血压和糖尿病的患病率更高。在每个测量时间点,他们的BMI和超重情况更高,而BMI降低幅度更低。体重反弹与CTS发病率增加无关。最后,发现体重减轻越多与CTS发病率降低幅度越大之间存在直接相关性。
发现减肥手术与CTS发病率降低有关。存在剂量反应关系,即减肥手术后体重减轻越多对CTS发病具有保护作用。