Guner Celik1, Mustafa Kemal Ilik. 1. *Department of Neurology, Faculty of Medicine, Baskent University, Konya, Turkey; and †Department of Neurosurgery, Farabi Hospital, Veysel Karani Street, Selcuklu, Konya, Turkey.
Abstract
PURPOSE: The optimal therapy for moderately severe carpal tunnel syndrome (CTS) remains unclear. In this study, the authors aimed at comparing the clinical and electrophysiologic recovery of CTS after local steroid injection and operation. METHODS: This is a clinical prospective study consisting of 100 patients with moderate CTS. The patients were diagnosed electrophysiologically with isolated median nerve neuropathy and had CTS symptoms for at least 3 months. While the patients undergoing local steroid injection were defined as injection group (42 women, 8 men and n = 50), other participants undergoing surgery were defined as operation group (47 women, 3 men and n = 50). The severity of the symptoms and electrophysiologic findings were evaluated before and at the first, third, and sixth months after the treatment. RESULTS: The authors found that all parameters were improved at the end of the first month in both groups. However, the recovery of all parameters increased at the third month and was statistically higher in operation group, compared with injection group. Furthermore, the recovery rate of distal sensory latencies and the visual analog scale scores was decreased in injection group at the third month. The authors observed that the recovery continued in both groups in the sixth month, and the rates of recovery were markedly lower in injection group than in operation group, compared with those obtained at the first month. CONCLUSIONS: The clinical recovery was more pronounced than the electrophysiologic recovery. And surgery is more effective technique than steroid injection for the treatment of the moderate CTS in the long term.
PURPOSE: The optimal therapy for moderately severe carpal tunnel syndrome (CTS) remains unclear. In this study, the authors aimed at comparing the clinical and electrophysiologic recovery of CTS after local steroid injection and operation. METHODS: This is a clinical prospective study consisting of 100 patients with moderate CTS. The patients were diagnosed electrophysiologically with isolated median nerve neuropathy and had CTS symptoms for at least 3 months. While the patients undergoing local steroid injection were defined as injection group (42 women, 8 men and n = 50), other participants undergoing surgery were defined as operation group (47 women, 3 men and n = 50). The severity of the symptoms and electrophysiologic findings were evaluated before and at the first, third, and sixth months after the treatment. RESULTS: The authors found that all parameters were improved at the end of the first month in both groups. However, the recovery of all parameters increased at the third month and was statistically higher in operation group, compared with injection group. Furthermore, the recovery rate of distal sensory latencies and the visual analog scale scores was decreased in injection group at the third month. The authors observed that the recovery continued in both groups in the sixth month, and the rates of recovery were markedly lower in injection group than in operation group, compared with those obtained at the first month. CONCLUSIONS: The clinical recovery was more pronounced than the electrophysiologic recovery. And surgery is more effective technique than steroid injection for the treatment of the moderate CTS in the long term.