Carpal tunnel releasecarpal tunnel syndromeelectrodiagnostic studyendoscopic

BackhroundsThe value of electrodiagnostic (EDX) study grades as a prognostic indicator of clinicalresults after carpal tunnel release (CTR) remains controversial. In this study, we tested the primary null hypothesis that symptom relief after CTR would not differ basedon EDX grade. Secondarily, we evaluated the degree of symptomatic and functionalpostoperative improvement relative to preoperative EDX gradMethodsWe prospectively evaluated 199 consecutive patients with 256 hands after CTRconfirmed with EDX. Data were collected before surgery and patients were observedat 2 weeks and 3 months after surgery. There were 20 hands with mild, 126 withmoderate, and 110 with severe involvement in the preoperative EDX. Demographic,EDX grade (mild, moderate, or severe); surgical parameters; Quick–Disabilities of theArm, Shoulder, and Hand questionnaire; symptom severity scale, functional statusscale, pain catastrophizing scale, and visual analog scale data were collected andanalyzed.ResultsThere was significant improvement in Quick–Disabilities of the Arm, Shoulder,and Hand, symptom severity scale, and functional status scale scores from thepreoperative to -2week and -3month postoperative visits in all categories of EDXgrade. There was no significant difference in the extent of recovery by the -2weekand -3month visits relative to EDX grade. Catastrophic thinking did not have asignificant effect on any of the 3 groups. Pain decreased dramatically at 2 weeksafter surgery but there was no additional significant difference in visual analog scalescores between the -2week and -3month postoperative visits. Postoperative painimprovement occurred regardless of EDX grade. There were no major complicationsor reoperations in any group.ConclusionsCarpal tunnel release demonstrated consistently significant improvement in outcomesregardless of EDX grade at initial and final follow-up. The extent of postoperativeimprovement after CTR overall was also not statistically different between groupswith differing EDX severity. Older patients with severe CTS achieved more modestgains.