Article
Surgical therapy for peripheral nerve compression syndromes of the upper extremity – results of a single centre with special reference to additional degenerative disease of the cervical spine
Periphere Nervenkompressionssyndrome der oberen Extremität – postoperativer Verlauf nach Dekompression unter besonderer Berücksichtigung zusätzlicher degenerativer Erkrankungen der Halswirbelsäule
Search Medline for
Authors
-
Dörthe Keiner
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
-
Joachim Oertel
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
| Published: | June 26, 2020 |
|---|
Outline
Text
Objective: The presented study focuses on surgical results for treatment of common nerve entrapment syndromes of the upper extremity in a single center with special attention on patients with diagnosed carpal tunnel and cubital tunnel syndrome and additional degenerative disease of the cervical spine with and without previous surgery.
Methods: Between 01/2011 and 05/2018, 170 patients (195 hands) were surgically treated for carpal tunnel syndrome (CTS) and 202 patients (220 elbows) were treated surgically for cubital tunnel syndrome (CuTS). Data of surgery and possible peculiarities, the postoperative course regarding objective improvement of symptoms and patient satisfaction was analyzed retrospectively.
Results: Cervical spine degeneration including severe disease such as myelopathy was diagnosed in 39.9% of CTS cases and in 32.4% of CuTS cases. In CTS, brachialgia resolved completely / improved markedly in 97.1% of cases with additional spine degeneration and in 96.9% of cases without this diagnosis. The improvement of sensory function in CTS patients with or without cervical spine disease was equal (p = 0.39). Improvement of motor function was significantly better in patients with cervical spine disease (p = 0.01), whereas preoperative comparison did not show a significant difference. In patients treated for CuTS, symptom relief was good in patients with and without cervical spine disease. Advanced symptoms were observed in a higher proportion of patients without a history of cervical spine disease. Postoperatively, results were favorable in patients with cervical spine disease showing a complete or marked recovery of motor symptoms in 80.6% of cases (p = 0.01), and of sensory symptoms in 72% of cases (p = 0.3). In the remaining patients, a complete or marked recovery of motor symptoms was found in 72.9% of cases, and a complete or marked recovery of sensory symptoms was observed in 54.9% of cases.
Conclusion: Patients with additional degenerative disease of the spine had a marked improvement after surgery for CTS or CuTS. Degenerative disease of the spine did not seem to affect the outcome in a negative way. With thorough preoperative diagnosing, the results are favorable. Surgical decompression of the nerve was not connected to inferior results or special risks.
