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微型开放性腕管减压术中远端运动潜伏期的术中变化作为临床结局的预测指标:一项回顾性队列研究

Intraoperative change in distal motor latency as a predictor for clinical outcome after mini-OCTR: a retrospective cohort study.

作者信息

Zhou Mingjie, Chen Chuxiang, Xu Chenpei, Yan Biao, Liverneaux Philippe, Jiang Su

机构信息

Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China.

National Health Commission Key Laboratory of Hand Reconstruction, Shanghai, China.

出版信息

Front Neurol. 2025 Aug 13;16:1607199. doi: 10.3389/fneur.2025.1607199. eCollection 2025.


DOI:10.3389/fneur.2025.1607199
PMID:40881796
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12381590/
Abstract

INTRODUCTION: Although mini-open carpal tunnel release (Mini-OCTR) proves to be a standard solution for carpal tunnel syndrome (CTS), precise prediction of recovery remains challenging. The aim of this study was to explore the potential of using intraoperative change in distal motor latency (DML) to predict clinical outcomes. METHODS: A retrospective cohort analysis was performed on 52 primary CTS patients, who completed the questionnaires before Mini-OCTR, 1 day (1 day Post-op) and 6 months after Mini-OCTR (6 months Post-op). Latency recovery percent (LRP) was calculated to represent intraoperative change of DML after Mini-OCTR. Multivariate and simple logistic regression analyses were used to quantify the predictive value of LRP on postoperative outcomes. RESULTS: The results of patient-reported outcome measures (PROMs) demonstrated that Mini-OCTR was an effective procedure in treating CTS generally with some of the patients experiencing significant improvement in sensory function at 1 day Post-op. Multivariate logistic regression analysis which involves demographic information, CTS-related medical history, electrodiagnostic test results, PROMs and LRP revealed that the prognostic model has high AUC and accuracy, and LRP is a significant predictor among all the involved variables. Simple logistic regression analysis identified an optimal LRP cut-off value of 0.11 for predicting sensory recovery at 1 day Post-op with high accuracy. CONCLUSION: This study introduces LRP as a practical biomarker that enables surgeons to predict immediate postoperative sensory improvement in Mini-OCTR patients, which can assist surgeons in setting short-term expectations and tailoring postoperative care for the patients.

摘要

引言:尽管小切口腕管松解术(Mini - OCTR)已被证明是治疗腕管综合征(CTS)的标准方法,但准确预测恢复情况仍然具有挑战性。本研究的目的是探讨利用术中远端运动潜伏期(DML)的变化来预测临床结果的可能性。 方法:对52例原发性CTS患者进行回顾性队列分析,这些患者在Mini - OCTR术前、术后1天(术后1天)和术后6个月(术后6个月)完成了问卷调查。计算潜伏期恢复百分比(LRP)以代表Mini - OCTR术后DML的术中变化。采用多变量和简单逻辑回归分析来量化LRP对术后结果的预测价值。 结果:患者报告结局测量(PROMs)结果表明,Mini - OCTR总体上是治疗CTS的有效方法,部分患者在术后1天感觉功能有显著改善。涉及人口统计学信息、CTS相关病史、电诊断测试结果、PROMs和LRP的多变量逻辑回归分析显示,该预后模型具有较高的AUC和准确性,并且LRP是所有涉及变量中的重要预测因子。简单逻辑回归分析确定预测术后1天感觉恢复的最佳LRP临界值为0.11,准确性较高。 结论:本研究引入LRP作为一种实用的生物标志物,使外科医生能够预测Mini - OCTR患者术后立即出现的感觉改善情况,这有助于外科医生设定短期预期并为患者量身定制术后护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/717115279326/fneur-16-1607199-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/c2df692c37cc/fneur-16-1607199-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/699b3eeae069/fneur-16-1607199-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/794e7e20c487/fneur-16-1607199-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/717115279326/fneur-16-1607199-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/c2df692c37cc/fneur-16-1607199-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/699b3eeae069/fneur-16-1607199-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/794e7e20c487/fneur-16-1607199-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d641/12381590/717115279326/fneur-16-1607199-g004.jpg

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本文引用的文献

[1]
Assessment of the Impact of Specialized Physical Therapy on the Clinical Condition of Patients After Carpal Tunnel Release.

Cureus. 2025-4-18

[2]
A multi-classifier system integrated by clinico-histology-genomic analysis for predicting recurrence of papillary renal cell carcinoma.

Nat Commun. 2024-7-23

[3]
Predictors of pain intensity in carpal tunnel syndrome: Development and validation of a model.

Clin Neurol Neurosurg. 2024-8

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Nat Rev Dis Primers. 2024-5-23

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PLoS One. 2024

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Bioengineering (Basel). 2024-2-11

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Neurosurgery. 2024-2-1

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J Hand Surg Glob Online. 2023-8-29

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Diagnosis of carpal tunnel syndrome using a 10-s grip-and-release test with video and machine learning analysis.

J Hand Surg Eur Vol. 2024-5

[10]
Deep Learning-Based Approaches for Enhanced Diagnosis and Comprehensive Understanding of Carpal Tunnel Syndrome.

Diagnostics (Basel). 2023-10-14

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