Abstract
Background
Cubital tunnel syndrome caused by ganglion cysts is rare and reports are few. This study aimed to review a patient cohort with ganglion cysts in the cubital tunnel and identify prognostic factors.
Methods
Fifty-seven patients (59 extremities; McGowan grade I, 4; IIa, 4; IIb, 3; III, 48) were evaluated retrospectively with a minimum follow-up of 2 years. Extraneural cysts were excised completely, while intraneural cysts were incised and drained. All cases underwent subcutaneous transposition. Spearman’s rank correlation and the ordinal logistic regression model were used to assess the effect of independent variables on the postoperative McGowan grade.
Results
VAS pain and weakness, 2-PD, key-pinch strength, grip strength, first dorsal interosseous muscle strength, Wartenberg sign, and claw hand all improved significantly. DASH scores improved from an average of 43.8 points preoperatively to 10.7 points postoperatively. According to the modified Bishop scoring system, 55 extremities (93.2%) were graded good or excellent. At the last follow-up, 29 hands (49.2%) returned to normal, and improvement by at least one McGowan grade was reached in 51 cases (86.4%). Older age, smoking, and shorter postoperative follow-up were associated with a higher postoperative McGowan grade.
Conclusions
Satisfactory surgical outcomes could be expected in these patients following subcutaneous transposition with excision of extraneural cysts and draining of intraneural cysts. Older age, smoking, and shorter postoperative follow-up were found to be independent risk factors for poor outcomes.
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Acknowledgements
This study was funded by a grant from National Natural Science Foundation of China, grant no. 81371374.
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The National Natural Science Foundation of China provided financial support in the form of the General Program of National Natural Science Foundation, grant no. 81371374. The sponsor had no role in the design or conduct of this research.
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An interesting article describing the successful surgical treatment of a relatively unusual cause of ulnar neuropathy, ganglion cysts involving the nerve across the elbow.
Michel Kliot
Stanford, California
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Tong, J., Xu, B., Dong, Z. et al. Cubital tunnel syndrome caused by ganglion cysts: a review of 59 cases. Acta Neurochir 159, 1265–1271 (2017). https://doi.org/10.1007/s00701-017-3180-6
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DOI: https://doi.org/10.1007/s00701-017-3180-6