Carpal Tunnel Syndrome Treatment and the Subsequent Alterations in Median Nerve Transverse Mobility.
Carpal Tunnel Syndrome Treatment and the Subsequent Alterations in Median Nerve Transverse Mobility.
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DOI：
10.1002/jum.15535
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发表时间：
2021-08
期刊：
影响因子：
--
通讯作者：
Amadio PC
中科院分区：
文献类型：
--
作者：
Hosseini-Farid M;Schrier VJMM;Starlinger J;Amadio PC
腕管综合征（CTS）患者的正中神经的活动性（横向运动）降低，可以通过超声非侵入性地测量。迄今为止，很少有预后特征可以帮助预测两种常用治疗方法的结果，即外科腕管松解术（CTR）和皮质类固醇注射。本研究旨在评估干预后神经活动性的变化，并将其与治疗和疾病严重程度相关联。总共招募了 181 名不同电生理严重程度的 CTS 患者，并在治疗前后对正中神经进行动态超声扫描进行评估。在进行手指和手腕弯曲时收集动态超声图像。对于注射和 CTR，神经位移随着手腕弯曲而增加，从 7.0 (±2.4 SD) 毫米增加到 7.9 (±2.7 SD) 毫米 (p<0.005)。与注射患者相比，接受手术的患者神经活动能力有更大的改善（p<0.005）。我们还观察到，神经活动性的增加主要发生在基线时神经损伤较多的患者中。本研究表明，正中神经的动态行为会因治疗而发生变化，并为未来评估神经活动测量的预后潜力的研究奠定了基础。
The mobility (transversal movement) of the median nerve is decreased in carpal tunnel syndrome (CTS) patients and can be measured non-invasively by ultrasound. To date, there are few prognostic features to help predict the outcome of two commonly performed treatments, surgical carpal tunnel release (CTR) and corticosteroid injections. This study aimed to assess the changes in nerve mobility after the intervention and to correlate this with treatment and disease severity. A total of 181 CTS patients with different electrophysiological severities were recruited and assessed by dynamic ultrasound scanning of the median nerve before and after treatment. The dynamic ultrasound images were collected while performing finger and wrist flexion. For both injection and CTR, the nerve displacement increased with wrist flexion, from 7.0 (±2.4 SD) to 7.9 (±2.7 SD) mm (p<0.005). Patients who underwent surgery showed bigger improvement (p<0.005) in nerve mobility compared to injection patients. We also observed that the increase in nerve mobility was predominantly in patients with more nerve damage at baseline. The present study shows that the dynamic behavior of the median nerve changes in response to treatment and lays a foundation for future studies to assess the prognostic potential of nerve mobility measurement.
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