Sonographic follow-up after endoscopic carpal tunnel release for severe carpal tunnel syndrome: a one-year neuroanatomical prospective observational study

摘要: Endoscopic carpal tunnel release (ECTR) has been gradually adopted for the treatment of severe syndrome (CTS). However, perioperative assessment neuroanatomical parameters median nerve, which are important determinant nerve recovery, rarely reported. This one-year prospective study aimed to investigate natural history morphology after ECTR in CTS patients by high-frequency ultrasonography and assess ability measures quantify morphological recovery ECTR. recruited 31 (44 wrists) with a definitive diagnosis underwent operation. The edema length (EL) from inlet proximal wrist was detected on long axis imaging plane anteroposterior diameter (D) cross-sectional area (CSA) at short were high frequency ultrasound. All these metrics 3 days before surgery 2nd week, 4th 3rd month, 6th month 12th separately. There no significant difference each parameter between 2-week postoperative (1.914 ± 0.598 cm EL, 0.258 ± 0.039 cm D 0.138 ± 0.015 cm2 CSA) 3-days preoperative time points (P-EL =0.250; P-D = 0.125; P-CSA =0.712). From fourth week third surgery, quickly improved. EL (0.715 ± 0.209 cm), (0.225 ± 0.017 cm) CSA (0.117 ± 0.012 cm2) 3- more reduced than < 0.001; P-D = 0.038; =0.014). Thereafter, neurological anatomy recovered slowly. By 12-month points, three neuroanatomically close normal. Compared control group (0.213 ± 0.005 cm), there point (0.214 ± 0.009 cm, P = 0.939). (0.098 ± 0.030 cm vs. 0.016 ± 0.011 cm) (0.103 ± 0.008 cm2 0.073 ± 0.005 cm2) healthy volunteers still existed < 0.001). Neuroanatomical improved surgery. best US follow up is 3-month who do not show clinical improvement, since this change greatest most patients. registered Chinese Clinical Trial Registry: ChiCTR-ROC-17014068 (retrospectively 20-12-2017).