D Ochoa-Cacique1, M E Córdoba-Mosqueda2, J R Aguilar-Calderón3, U García-González4, A Ibarra-De la Torre5, V A Reyes-Rodríguez6, J D J Lomelí-Ramírez7, Ó Medina-Carrillo8, M D Sánchez-Calderón9, E A Castañeda-Ramírez10. 1. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: diego2_doc@hotmail.com. 2. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: dramaelenacmosqueda@gmail.com. 3. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: jcalderon02@yahoo.com. 4. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: ulises.med@gmail.com. 5. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: abraham_ibarra2017@outlook.com. 6. Department of Neurosurgery, Hospital Central Norte PEMEX, Campo Matillas 52, San Antonio, Azcapotzalco, 02720 Mexico City, Mexico. Electronic address: neurovican@hotmail.com. 7. Department of Neurosurgery, Hospital Vossan, Carretera Lerma-Champotón km 193, Country club, 24500 Campeche, Mexico. Electronic address: joselomeli@prodigy.net.mx. 8. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: dromecar@gmail.com. 9. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: marisancal@gmail.com. 10. Department of Neurosurgery, Hospital Central Sur de Alta Especialidad de Alta Especialidad de PEMEX, Periferico sur 4091, Fuentes del Pedregal, Tlalpan, 14140 Mexico City, Mexico. Electronic address: erickcastanedar@gmail.com.
Abstract
BACKGROUND: Double Crush Syndrome (DCS) is a clinical condition that involves multiple compression sites along a single peripheral nerve. The present study aims to describe the epidemiology of DCS and surgical results. METHODS: A retrospective observational analytic study included patients with clinical diagnosis of cervical radiculopathy and carpal tunnel syndrome who underwent surgery between January 2009 and January 2019. General demographic characteristics were noted, and 3 groups were distinguished: spinal surgery, carpal tunnel release, and bimodal decompression (BD); statistical differences were analyzed between them. RESULTS: The sample comprised 32 patients. DCS prevalence was 10.29%. Mean age at presentation was 59.25±10.98 years. There was female predominance (75%). Paresthesia was the main symptom (65.6%). Post-surgical results of BD showed significant improvement in sensory nerve conduction velocity, motor nerve conduction velocity (both P=0.008), and disability on Douleur Neuropathique 4 questions, Neck Disability Index, and Boston Carpal Tunnel Questionnaire (P=0.001, 0.004, 0.008, respectively). CONCLUSIONS: Diagnosis and management of DCS are a challenge. It is necessary to determine the site with maximal compression and risk of complications to decide on treatment. If first-line surgery is adequate, proximal and distal symptomatology can be improved. To maximize success, we recommend BD, according to the present results.
BACKGROUND:Double Crush Syndrome (DCS) is a clinical condition that involves multiple compression sites along a single peripheral nerve. The present study aims to describe the epidemiology of DCS and surgical results. METHODS: A retrospective observational analytic study included patients with clinical diagnosis of cervical radiculopathy and carpal tunnel syndrome who underwent surgery between January 2009 and January 2019. General demographic characteristics were noted, and 3 groups were distinguished: spinal surgery, carpal tunnel release, and bimodal decompression (BD); statistical differences were analyzed between them. RESULTS: The sample comprised 32 patients. DCS prevalence was 10.29%. Mean age at presentation was 59.25±10.98 years. There was female predominance (75%). Paresthesia was the main symptom (65.6%). Post-surgical results of BD showed significant improvement in sensory nerve conduction velocity, motor nerve conduction velocity (both P=0.008), and disability on Douleur Neuropathique 4 questions, Neck Disability Index, and Boston Carpal Tunnel Questionnaire (P=0.001, 0.004, 0.008, respectively). CONCLUSIONS: Diagnosis and management of DCS are a challenge. It is necessary to determine the site with maximal compression and risk of complications to decide on treatment. If first-line surgery is adequate, proximal and distal symptomatology can be improved. To maximize success, we recommend BD, according to the present results.