Delayed Electrophysiological Recovery After Carpal Tunnel Release for Advanced Carpal Tunnel Syndrome: A Two-Year Follow-Up Study
Delayed Electrophysiological Recovery After Carpal Tunnel Release for Advanced Carpal Tunnel Syndrome: A Two-Year Follow-Up Study
复制标题
DOI：
10.1097/wnp.0b013e31827ed839
复制
发表时间：
2013-02-01
影响因子：
2.4
通讯作者：
Sumi, Masatoshi
中科院分区：
文献类型：
--
作者：
Kanatani, Takako;Fujioka, Hiroyuki;Sumi, Masatoshi
晚期腕管综合征表现为严重的鱼际萎缩，缺乏电生理运动和感觉反应。由于这些病症的严重性，手术后需要一段较长的恢复时间才能明显改善。在这项基于电生理学的研究中，在腕管松解后 1 年和 2 年评估了腕部刺激后拇短展肌远端运动潜伏期 (DML) 的再现和/或感觉神经传导速度 (SCV)。为了对结果进行分类，使用以下分级量表：I 期、正常 DML 和 SCV； II 期，DML >= 4.5 ms 且 SCV 正常； III 期，DML >= 4.5 ms 且 SCV < 40.0 ms； IV 期，DML >= 4.5 ms 且 SCV 不可测量；第五阶段：不可测量的 DML 和 SCV。作者发现可测量的 DML 和/或 SCV，以及术后 1 年和 2 年的显着改善。此外，康复至轻度腕管综合征（I 期或 II 期）的患者比例显着增加。他们得出的结论是，使用上述分级量表对晚期腕管综合征的 DML 和 SCV 进行电生理评估，作为腕管松解术后恢复的客观评估工具是有效的。
Advanced carpal tunnel syndrome presents severe thenar atrophy with the absence of electrophysiological motor and sensory responses. Because of severity of these conditions, a substantial period of recovery after surgery is required before improvement becomes evident. In this electrophysiological-based study, the reappearance of distal motor latency (DML) at the abductor pollicis brevis and/or sensory nerve conduction velocity (SCV) after wrist stimulation were evaluated 1 year and 2 years after carpal tunnel release. To categorize outcomes, the following grading scale was used: stage I, normal DML and SCV; stage II, DML >= 4.5 ms and normal SCV; stage III, DML >= 4.5 ms and SCV < 40.0 ms; stage IV, DML >= 4.5 ms and nonmeasurable SCV; stage V: nonmeasurable DML and SCV. The authors found measurable DML and/or SCV and significant improvement both 1 year and 2 years postoperatively. Furthermore, the percentage of patients who recovered to the extent that they presented as mild carpal tunnel syndrome (stage I or II) increased significantly. They conclude that electrophysiological assessment of DML and SCV of advanced carpal tunnel syndrome using the above grading scale was effective as an objective evaluation tool of recovery after carpal tunnel release.