Prevalence of decompression surgery in patients with carpal tunnel syndrome 8 years after initial treatment with a local corticosteroid injection
Prevalence of decompression surgery in patients with carpal tunnel syndrome 8 years after initial treatment with a local corticosteroid injection
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DOI：
10.1177/1753193416671102
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发表时间：
2017-03
期刊：
影响因子：
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通讯作者：
A. Hameso;J. Bland
中科院分区：
文献类型：
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作者：
A. Hameso;J. Bland
反复局部注射皮质类固醇已成为治疗腕管综合征的常见模式，尽管现有的建议是不应超过三次注射。我们研究了2007年期间最初选择在腕管内注射皮质类固醇的254名患者的临床结果。获得了157名患者的随访治疗记录，其中41%的患者在2015年之前进行了手术。手术前平均注射1.9次。在未手术组，平均再注射两次(范围0-12)。使用波士顿腕管问卷测量的最终主观严重程度和功能状态评分，手术组显著低于未手术组，但两组均较基线有显著改善。最终得分之间的差异小于这些测量的估计的最小临床重要差异。我们得出结论，反复注射类固醇可能是一些腕管综合征患者的有效治疗选择。证据级别：三
Repeated local corticosteroid injections have become a common mode of treatment for carpal tunnel syndrome, despite an existing recommendation that no more than three injections should be given. We studied the clinical outcomes in 254 patients who initially opted for a corticosteroid injection into their carpal canal during 2007. Follow-up records of treatment were obtained for 157 patients of whom 41% had proceeded to surgery by 2015. A mean of 1.9 injections had been given before surgery. In the unoperated group, a mean of two (range 0–12) further injections had been given. The final subjective severity and functional status scores measured using the Boston carpal tunnel questionnaire were significantly lower in the operated than in the unoperated group, but both groups improved significantly from baseline. The differences between the final scores are less than the estimated minimal clinically important difference for these measures. We conclude that repeated steroid injection may be a valid treatment option for some patients with carpal tunnel syndrome. Level of evidence: III