Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome
Abstract Background Most cases of entrapment neuropathy are due to median nerve compression, which manifests most commonly as carpal tunnel syndrome (CTS). There are several nonsurgical treatment options available for mild-to-moderate circumstances. Aim To assess the effect of ultrasound-guided perc...
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SpringerOpen
2025-01-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-024-01378-w |
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| author | Ahmed M. Zidan Hytham Mohamed Nafady Mohamed Abdelrahman Alkenawy Mohammad Abol Wafa Ahmad Ahmed Mohamed Eldeeb Mohamed Talaat Mohamed Mahmoud Mohamed Aboumandour Fouda Hasan A. Soltan Nehal Elsayed Shabaan Ahmed B. M. Mehany Yasser Fouad Ghoraba |
| author_facet | Ahmed M. Zidan Hytham Mohamed Nafady Mohamed Abdelrahman Alkenawy Mohammad Abol Wafa Ahmad Ahmed Mohamed Eldeeb Mohamed Talaat Mohamed Mahmoud Mohamed Aboumandour Fouda Hasan A. Soltan Nehal Elsayed Shabaan Ahmed B. M. Mehany Yasser Fouad Ghoraba |
| author_sort | Ahmed M. Zidan |
| collection | DOAJ |
| description | Abstract Background Most cases of entrapment neuropathy are due to median nerve compression, which manifests most commonly as carpal tunnel syndrome (CTS). There are several nonsurgical treatment options available for mild-to-moderate circumstances. Aim To assess the effect of ultrasound-guided percutaneous flexor retinaculum fenestration on the outcome of hydrostatic dissection of the median nerve in cases with CTS. Methods This randomized clinical research included a total of 54 individuals with CTS separated into two groups; group (A) included patients with hydrostatic dissection with adjuvant fenestration of transverse carpal ligament (n = 27), while group (B) involved patients with hydrostatic dissection alone (n = 27). Pain and disability through the visual analog scale (VAS), symptom severity (SS) score, modified Boston Carpal Tunnel Questionnaire (BCTQ), and functional disability (FD) score before injection and 3 months post-injection were assessed. Distal motor latency (DML) and sensory conduction velocity (SCV) were measured at baseline and 3 months after the procedure. Results SS and FD scores, were comparable in both groups before the procedure, while after three months of the procedure, the mean of SS and FD scores was significantly higher in group A (24.18 ± 3.62 and 17.52 ± 2.15, respectively) than in group B (16.55 ± 3.17and 11.39 ± 1.81, respectively) (p < 0.001). Also, there was a significant distinction between before and after the procedure in both groups (p < 0.001). Regarding electro physiologic outcomes, DML and SCV were comparable in both groups before the procedure, while after three months of the procedure, the mean of DML and SCV scores was significantly higher in group A (4.41 ± 0.41 and 39.27 ± 2.35, correspondingly) than group B (4.23 ± 0.37and 42.55 ± 2.75, respectively) (p = 0.011 and < 0.001, correspondingly). Also, there was significant variance between before & after the procedure in both groups (p = 0.010 and < 0.001, correspondingly). Conclusion Ultrasound-guided hydro-dissection and fenestration of the transvers carpal ligament is a simple, non-invasive treatment for CTS that has the potential to reduce symptoms for a long time and delay or perhaps prevent the need for open release. |
| format | Article |
| id | doaj-art-c5498612ecdb4342b39d76d71ec19348 |
| institution | Kabale University |
| issn | 2090-4762 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj-art-c5498612ecdb4342b39d76d71ec193482025-01-12T12:12:41ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622025-01-0156111010.1186/s43055-024-01378-wImpact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndromeAhmed M. Zidan0Hytham Mohamed Nafady1Mohamed Abdelrahman Alkenawy2Mohammad Abol Wafa Ahmad3Ahmed Mohamed Eldeeb4Mohamed Talaat Mohamed5Mahmoud Mohamed Aboumandour Fouda6Hasan A. Soltan7Nehal Elsayed Shabaan8Ahmed B. M. Mehany9Yasser Fouad Ghoraba10Radio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadio-Diagnosis Department, Faculty of Medicine, Al-Azhar UniversityRadiology Department, Faculty of Medicine, Aswan Universityry Department, Faculty of Medicine, Tanta UniversityGenetic Engineering, Zoology Department, Faculty of Science, Al-Azhar Universityry Department, Faculty of Medicine, Tanta UniversityAbstract Background Most cases of entrapment neuropathy are due to median nerve compression, which manifests most commonly as carpal tunnel syndrome (CTS). There are several nonsurgical treatment options available for mild-to-moderate circumstances. Aim To assess the effect of ultrasound-guided percutaneous flexor retinaculum fenestration on the outcome of hydrostatic dissection of the median nerve in cases with CTS. Methods This randomized clinical research included a total of 54 individuals with CTS separated into two groups; group (A) included patients with hydrostatic dissection with adjuvant fenestration of transverse carpal ligament (n = 27), while group (B) involved patients with hydrostatic dissection alone (n = 27). Pain and disability through the visual analog scale (VAS), symptom severity (SS) score, modified Boston Carpal Tunnel Questionnaire (BCTQ), and functional disability (FD) score before injection and 3 months post-injection were assessed. Distal motor latency (DML) and sensory conduction velocity (SCV) were measured at baseline and 3 months after the procedure. Results SS and FD scores, were comparable in both groups before the procedure, while after three months of the procedure, the mean of SS and FD scores was significantly higher in group A (24.18 ± 3.62 and 17.52 ± 2.15, respectively) than in group B (16.55 ± 3.17and 11.39 ± 1.81, respectively) (p < 0.001). Also, there was a significant distinction between before and after the procedure in both groups (p < 0.001). Regarding electro physiologic outcomes, DML and SCV were comparable in both groups before the procedure, while after three months of the procedure, the mean of DML and SCV scores was significantly higher in group A (4.41 ± 0.41 and 39.27 ± 2.35, correspondingly) than group B (4.23 ± 0.37and 42.55 ± 2.75, respectively) (p = 0.011 and < 0.001, correspondingly). Also, there was significant variance between before & after the procedure in both groups (p = 0.010 and < 0.001, correspondingly). Conclusion Ultrasound-guided hydro-dissection and fenestration of the transvers carpal ligament is a simple, non-invasive treatment for CTS that has the potential to reduce symptoms for a long time and delay or perhaps prevent the need for open release.https://doi.org/10.1186/s43055-024-01378-wCarpal tunnel syndromeHydrostatic dissectionFlexor retinaculum fenestration |
| spellingShingle | Ahmed M. Zidan Hytham Mohamed Nafady Mohamed Abdelrahman Alkenawy Mohammad Abol Wafa Ahmad Ahmed Mohamed Eldeeb Mohamed Talaat Mohamed Mahmoud Mohamed Aboumandour Fouda Hasan A. Soltan Nehal Elsayed Shabaan Ahmed B. M. Mehany Yasser Fouad Ghoraba Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome The Egyptian Journal of Radiology and Nuclear Medicine Carpal tunnel syndrome Hydrostatic dissection Flexor retinaculum fenestration |
| title | Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| title_full | Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| title_fullStr | Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| title_full_unstemmed | Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| title_short | Impact of ultrasound-guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| title_sort | impact of ultrasound guided percutaneous flexor retinaculum fenestration on outcome of hydrostatic dissection of median nerve in patient with carpal tunnel syndrome |
| topic | Carpal tunnel syndrome Hydrostatic dissection Flexor retinaculum fenestration |
| url | https://doi.org/10.1186/s43055-024-01378-w |
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