Abstract
In the past few years, several different minimally invasive surgical techniques have been proposed to decompress the median nerve at the wrist. Use of these techniques has become widespread due to fewer local complications, faster functional recovery, and reduced surgical time. In this paper the authors compare 3 different minimally invasive surgical techniques used at their institution in the past 13 years. Between January 1994 and January 2007, 891 patients underwent 1272 surgeries at the authors' institution for carpal tunnel syndrome (CTS), for which a minimally invasive technique was used. In 473 cases (Group A), the transillumination technique with a single wrist incision and a "carpalotome" (a modified Paine retinaculotome) was used; in 216 cases (Group B), transillumination was abandoned and a single linear wrist incision for access with the carpalotome was performed; and in 583 cases (Group C), the techniques were further modified by making a second incision in the palm using the carpalotome. All 3 groups of patients were homogeneous for age, sex, and duration of the symptomatology. In 90% of the patients in Group A, in 88% of those in Group B, and 99.8% of patients in Group C, complete remission of symptoms was obtained. Due to persistence of symptoms, 44 patients in Group A, 24 in Group B, and only 1 in Group C underwent a repeated operation with the open technique. The only surgical complication requiring repeated operation of the 1272 operations was a lesion of the primitive median artery (1 patient in Group C). The technique of median nerve decompression at the wrist that was used for patients in Group C represents a valid alternative for treatment of CTS.
| Original language | English |
|---|---|
| Pages (from-to) | 1033-1036 |
| Number of pages | 4 |
| Journal | Journal of Neurosurgery |
| Volume | 108 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 2008 |
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Keywords
- Carpal tunnel syndrome
- Minimally invasive surgery
- Retinaculotome
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)
Cite this
Carpal tunnel syndrome : Matching minimally invasive surgical techniques. Technical note. / Nazzi, Vittoria; Franzini, Angelo; Messina, Giuseppe; Broggi, Giovanni.
In: Journal of Neurosurgery, Vol. 108, No. 5, 05.2008, p. 1033-1036.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Carpal tunnel syndrome
T2 - Matching minimally invasive surgical techniques. Technical note
AU - Nazzi, Vittoria
AU - Franzini, Angelo
AU - Messina, Giuseppe
AU - Broggi, Giovanni
PY - 2008/5
Y1 - 2008/5
N2 - In the past few years, several different minimally invasive surgical techniques have been proposed to decompress the median nerve at the wrist. Use of these techniques has become widespread due to fewer local complications, faster functional recovery, and reduced surgical time. In this paper the authors compare 3 different minimally invasive surgical techniques used at their institution in the past 13 years. Between January 1994 and January 2007, 891 patients underwent 1272 surgeries at the authors' institution for carpal tunnel syndrome (CTS), for which a minimally invasive technique was used. In 473 cases (Group A), the transillumination technique with a single wrist incision and a "carpalotome" (a modified Paine retinaculotome) was used; in 216 cases (Group B), transillumination was abandoned and a single linear wrist incision for access with the carpalotome was performed; and in 583 cases (Group C), the techniques were further modified by making a second incision in the palm using the carpalotome. All 3 groups of patients were homogeneous for age, sex, and duration of the symptomatology. In 90% of the patients in Group A, in 88% of those in Group B, and 99.8% of patients in Group C, complete remission of symptoms was obtained. Due to persistence of symptoms, 44 patients in Group A, 24 in Group B, and only 1 in Group C underwent a repeated operation with the open technique. The only surgical complication requiring repeated operation of the 1272 operations was a lesion of the primitive median artery (1 patient in Group C). The technique of median nerve decompression at the wrist that was used for patients in Group C represents a valid alternative for treatment of CTS.
AB - In the past few years, several different minimally invasive surgical techniques have been proposed to decompress the median nerve at the wrist. Use of these techniques has become widespread due to fewer local complications, faster functional recovery, and reduced surgical time. In this paper the authors compare 3 different minimally invasive surgical techniques used at their institution in the past 13 years. Between January 1994 and January 2007, 891 patients underwent 1272 surgeries at the authors' institution for carpal tunnel syndrome (CTS), for which a minimally invasive technique was used. In 473 cases (Group A), the transillumination technique with a single wrist incision and a "carpalotome" (a modified Paine retinaculotome) was used; in 216 cases (Group B), transillumination was abandoned and a single linear wrist incision for access with the carpalotome was performed; and in 583 cases (Group C), the techniques were further modified by making a second incision in the palm using the carpalotome. All 3 groups of patients were homogeneous for age, sex, and duration of the symptomatology. In 90% of the patients in Group A, in 88% of those in Group B, and 99.8% of patients in Group C, complete remission of symptoms was obtained. Due to persistence of symptoms, 44 patients in Group A, 24 in Group B, and only 1 in Group C underwent a repeated operation with the open technique. The only surgical complication requiring repeated operation of the 1272 operations was a lesion of the primitive median artery (1 patient in Group C). The technique of median nerve decompression at the wrist that was used for patients in Group C represents a valid alternative for treatment of CTS.
KW - Carpal tunnel syndrome
KW - Minimally invasive surgery
KW - Retinaculotome
UR - http://www.scopus.com/inward/record.url?scp=43249102755&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=43249102755&partnerID=8YFLogxK
U2 - 10.3171/JNS/2008/108/5/1033
DO - 10.3171/JNS/2008/108/5/1033
M3 - Article
C2 - 18447726
AN - SCOPUS:43249102755
VL - 108
SP - 1033
EP - 1036
JO - Journal of Neurosurgery
JF - Journal of Neurosurgery
SN - 0022-3085
IS - 5
ER -