Summary
48 patients with clinical and neurophysiological signs of carpal tunnel syndrome were randomized to any of two operative methods: Internal neurolysis of the median nerve with a microsurgical technique, or simple division of the carpal ligament (flexor retinaculum).
After a minimum follow-up period of 3 years 81% of the patients did not report any complaints at all, and all patients considered themselves improved after operation. There was no difference between the operation groups. Therefore there seems to be no justification to perform the more difficult procedure of internal microsurgical neurolysis for treatment of the carpal tunnel syndrome.
A study of the neurophysiological parameters before and after restitution showed the highest sensitivity (91%) for the sensory conduction velocity, and the highest specificity for motor distal latency and sensory distal latency (83 and 75% resp.).
Similar content being viewed by others
References
Aminoff MJ (1979) Involvement of peripheral vasomotor fibres in carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 42: 649–655
Buchtal F, Rosenfalck A, Trojaborg W (1974) Electrophysiological findings in entrapment of the median nerve at wrist and elbow. J Neurol Neurosurg Psychiatry 37: 340–360
Cseuz KA, Thomas JE, Lambert EH,etal (1966) Long-term results of operation for carpal tunnel syndrome. Mayo Clin Proc 41: 232–241
Gilliat RW, Wilson TG (1953) A pneumatic-tourniquet test in the carpal tunnel syndrome. Lancet 2: 595
Gilliat RW (1975) Peripheral nerve compression and entrapment. In: Lant AF (ed) Eleventh Symposium on Advanced Medicine, Royal College of Physicians of London. Pitman Medical Publishing, London
Holmgreen-Larsson H, Leszniewski W, Lindén U, Rabow L, Thorling J (1985) Internal neurolysis or Ligament division only in Carpal tunnel Syndrome-results of a randomized Study. Acta Neurochir (Wien) 74: 118–121
Lindblom U (1974) Touch perception threshold in human glabrous skin in terms of displacement amplitude on stimulation with single mechanical pulses. Brain Res 82: 205–210
Loong SC, Seah CS (1971) Comparison of median and ulnar sensory nerve action potentials in the diagnosis of the carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 34: 750–754
Loong SC (1977) The carpal tunnel syndrome: A clinical and electophysiological study of 250 patients. Proc Aust Assoc Neurol 14: 51–62
Rasminsky M (1973) The effects of temperature on conduction in demyelinated single nerve fibres. Arch Neurol 28: 287–295
Richer HP, Thodes U (1977) Early electroneurographic diagnosis of carpal tunnel syndrome. EEG/EMG 8: 187–191
Seddon HJ (1943) Three types of nerve injury. Brain 66: 237–242
Stoehr M, Petruch F, Scheglmann F, Schilling K (1978) Retrograde changes of nerve fibres with the carpal tunnel syndrome. J Neurol 218: 287–291
Thomas PK (1960) Motor nerve conduction in the carpal tunnel syndrome. Neurology 10: 1045–1050
Thomas JE, Lambert EH, Cseuz KA (1967) Electrodiagnostic aspects of the carpal tunnel syndrome. Arch Neurol 16: 635–641
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Holmgren, H., Rabow, L. Internal neurolysis or ligament division only in carpal tunnel syndrome II a 3 year follow-up with an evaluation of various neurophysiological parameters for diagnosis. Acta neurochir 87, 44–47 (1987). https://doi.org/10.1007/BF02076014
Issue Date:
DOI: https://doi.org/10.1007/BF02076014