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使用专用手术套件的新型微创腕管松解术:一项前瞻性多中心病例系列研究。

Novel minimally invasive carpal tunnel release using a specialized surgical kit: a prospective multi-center case series.

作者信息

Chen Hsuan-Fu, Chang Shun-Min, Kao Chih-Ming, Chen Yu-Lin, Kao Li-Ting, Hsu Ya-Chuan, Fu Yin-Chih, Wang Yan-Hsiung, Liu Wen-Chih, Lee Tien-Ching

机构信息

Department of Orthopedics, Division of Sports Medicine and Orthopaedic Trauma, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No.100, Tzyou 1 Road, Kaohsiung, 80756, Taiwan.

Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.

出版信息

BMC Musculoskelet Disord. 2025 Apr 8;26(1):346. doi: 10.1186/s12891-025-08612-0.

Abstract

BACKGROUND

Carpal tunnel syndrome (CTS) is the most common peripheral nerve compression neuropathy. While established surgical techniques have demonstrated reliable outcomes and safety profiles, innovations in minimally invasive approached continue to emerge. This study evaluates a novel minimally invasive surgical technique using a specialized instrument for carpal tunnel release.

METHODS

In this prospective multi-center case series, 41 patients underwent minimally invasive carpal tunnel release using a novel surgical kit. Outcomes were assessed through Visual Analog Scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), grip and pinch strength measurements, and nerve conduction velocity (NCV) testing at regular intervals over 24 weeks post-surgery.

RESULTS

Mean surgical time was 7.02 min. Significant improvements were observed in VAS scores (LS-Mean - 0.57, P < 0.0001) and BCTQ scores (Symptom Severity: LS-Mean - 2.62, P < 0.0001; Functional Status: LS-Mean - 1.20, P < 0.0001) by 24 weeks. Grip and pinch strengths showed significant improvement from 2 weeks post-surgery. Mean time to return to work was 18.2 days. NCV testing demonstrated significant improvements in both latency (LS-Mean - 0.57, P < 0.0001) and velocity (LS-Mean 5.79, P < 0.0001). One superficial infection and two cases of temporary numbness were reported, with no recurrent CTS observed.

CONCLUSIONS

This novel minimally invasive technique demonstrates promising clinical outcomes with shortened operative time, rapid symptom relief, and early functional recovery. While larger randomized studies are needed, these preliminary findings suggest this technique may be a valuable addition to current surgical options for CTS.

TRIAL REGISTRATION

Clinicaltrials.gov, NCT05067205. Prospectively registered, date of first registration: 05/10/2021 ( https://clinicaltrials.gov/study/NCT05067205 ).

摘要

背景

腕管综合征(CTS)是最常见的周围神经卡压性神经病变。虽然既定的手术技术已显示出可靠的疗效和安全性,但微创方法的创新仍在不断涌现。本研究评估了一种使用专门器械进行腕管松解的新型微创手术技术。

方法

在这个前瞻性多中心病例系列中,41例患者使用新型手术套件接受了微创腕管松解术。通过视觉模拟量表(VAS)、波士顿腕管问卷(BCTQ)、握力和捏力测量以及术后24周内定期进行的神经传导速度(NCV)测试来评估结果。

结果

平均手术时间为7.02分钟。术后24周时,VAS评分(最小二乘均值-0.57,P<0.0001)和BCTQ评分(症状严重程度:最小二乘均值-2.62,P<0.0001;功能状态:最小二乘均值-1.20,P<0.0001)有显著改善。握力和捏力从术后2周开始有显著改善。平均重返工作时间为18.2天。NCV测试显示潜伏期(最小二乘均值-0.57,P<0.0001)和速度(最小二乘均值5.79,P<0.000)均有显著改善。报告了1例浅表感染和2例暂时性麻木病例,未观察到复发性CTS。

结论

这种新型微创技术显示出有前景的临床结果,手术时间缩短、症状快速缓解且功能早期恢复。虽然需要更大规模的随机研究,但这些初步发现表明该技术可能是目前CTS手术选择中的一个有价值的补充。

试验注册

Clinicaltrials.gov,NCT05067205。前瞻性注册,首次注册日期:2021年10月5日(https://clinicaltrials.gov/study/NCT05067205)

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d5c/11980155/add1a4f4be6a/12891_2025_8612_Fig1_HTML.jpg

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