腕管松解术后长达一年的术前超声检查、神经传导研究及CTS-6与波士顿腕管问卷的相关性
Associations of Preoperative Ultrasonography, Nerve Conduction Studies, and CTS-6 to Boston Carpal Tunnel Questionnaires Up to One Year Following Carpal Tunnel Release.
作者信息
Dvorsky Jenna L, Lin Ryan T, Charles Shaquille, Kostyal Madalyn, Ong Hannah, Fowler John
机构信息
University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
出版信息
J Hand Surg Glob Online. 2025 Aug 13;7(5):100767. doi: 10.1016/j.jhsg.2025.100767. eCollection 2025 Sep.
PURPOSE
The purpose of this study was to evaluate the association between preoperative ultrasound, nerve conduction studies (NCS), and/or carpal tunnel syndrome-6 (CTS-6) scores and the postoperative courses of patients undergoing carpal tunnel release (CTR).
METHODS
This was a retrospective study of all patients indicated for CTR at a single institution between October 2014 and August 2021. Preoperative data, including age, sex, body mass index, and laterality of the involved hand(s), were collected. Ultrasound was performed with a median nerve cross-sectional area (CSA) of ≥10 mm considered positive for CTS. Nerve conduction studies evaluated the distal sensory and motor latencies of the median nerve. Carpal tunnel syndrome-6 scores ≥12 were considered positive for CTS. The primary outcome measurement was the Boston Carpal Tunnel Questionnaire (BCTQ). Statistical analysis was performed to assess the correlation of preoperative studies to predict changes in postoperative BCTQ scores following CTR. Statistical significance was set to < .05.
RESULTS
In total, 106 patients were included in the analysis, of which 69 patients were positive for CTS on US with an average median nerve CSA of 15.2 ± 4.4 mm, whereas 37 patients were negative with an average CSA of 9.0 ± 1.3 mm ( < .001). Female sex, height, and weight were significantly different between the CTS-positive and -negative cohorts ( = .01, = .02, and = .01). Preoperative US, NCS, and CTS-6 were not associated with the ability to achieve minimal clinically important difference in change in BCTQ scores after surgery.
CONCLUSIONS
Although helpful in establishing a diagnosis of CTS, positive findings on preoperative US, NCS, and CTS-6 alone are not associated with clinically significant changes in BCTQ symptom or function scores up to 1 year after surgery following CTR.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
目的
本研究旨在评估术前超声、神经传导研究（NCS）和/或腕管综合征-6（CTS-6）评分与接受腕管松解术（CTR）患者术后病程之间的关联。
方法
这是一项对2014年10月至2021年8月期间在单一机构接受CTR治疗的所有患者进行的回顾性研究。收集术前数据，包括年龄、性别、体重指数和受累手的侧别。超声检查时，正中神经横截面积（CSA）≥10 mm被视为CTS阳性。神经传导研究评估正中神经的远端感觉和运动潜伏期。CTS-6评分≥12被视为CTS阳性。主要结局指标是波士顿腕管问卷（BCTQ）。进行统计分析以评估术前研究与预测CTR术后BCTQ评分变化之间的相关性。设定统计学显著性为<0.05。
结果
总共106例患者纳入分析，其中69例患者超声检查CTS阳性，正中神经平均CSA为15.2±4.4 mm，而37例患者为阴性，平均CSA为9.0±1.3 mm（<0.001）。CTS阳性和阴性队列之间的女性性别、身高和体重存在显著差异（分别为=0.01、=0.02和=0.01）。术前超声、NCS和CTS-6与术后BCTQ评分变化达到最小临床重要差异的能力无关。
结论
尽管术前超声、NCS和CTS-6有助于CTS的诊断，但仅这些阳性结果与CTR术后长达1年的BCTQ症状或功能评分的临床显著变化无关。
研究类型/证据水平：预后性IV级。
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