Document Type : Original Article
Assistant professor of orthopedic surgery, Orthopedic research center, Mazandaran university of medical science, Sari, Iran.
Associate professor of orthopedic surgery, Orthopedic research center, Mazandaran university of medical science, Sari, Iran.
Resident of orthopedic surgery, Orthopedic research center, Mazandaran university of medical science, Sari, Iran.
Introduction: Carpal tunnel syndrome (CTS) is a symptomatic compression neuropathy of the median nerve in the wrist. The purpose of this comparative study was to evaluate the clinical outcomes of median nerve release in CTS with and without cervical radiculopathy (CR) in patients referred to orthopedic research centers in Sari, Iran, to answer the question of whether the CR patients need to be referred for proximal decompression spine surgery.
Methods: The patients were selected in two groups of 30 patient (CTS with and without cervical radiculopathy). The patients in the CR group were selected based on involvement in electromyography (EMG)/nerve conduction velocity (NCV). This study examined the variables of grip and pinch strength, QuickDASH questionnaire, Boston symptom severity scale (BQ-SS), Boston Questionnaire-Functional Scale (BQ-FS) and VAS index before surgery, three months and six months after surgery.
Results: the scores of grip and pinch strength, BQ-FS and BQ-SS, QuickDASH and VAS had a significant decrease in three months and six months after surgery compared to before surgery between the two groups (P<0.05). There was no significant difference between the two groups in terms of reduction rate (P>0.05). The results of repeated measures ANOVA test also showed that the correlation between BQ-SS and VAS in patients according to the study groups in different time periods is significant, so that BQ-SS and VAS scores decreased after median nerve release in both groups but the decrease trend was significantly higher in the CTS group without CR than in the CTS group with CR (P<0.001).
Conclusion: it can be concluded that the median nerve release can be effective in two groups, and six-month follow-up in patients with CR revealed that there is no need for referral for proximal decompression spine surgery