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Acta Neurochirurgica

, Volume 87, Issue 1–2, pp 44–47 | Cite as

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

  • Helen Holmgren
  • L. Rabow
Article

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.).

Keywords

Carpal tunnel syndrome internal neurolysis neurophysiological parameters 

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References

  1. 1.
    Aminoff MJ (1979) Involvement of peripheral vasomotor fibres in carpal tunnel syndrome. J Neurol Neurosurg Psychiatry 42: 649–655PubMedGoogle Scholar
  2. 2.
    Buchtal F, Rosenfalck A, Trojaborg W (1974) Electrophysiological findings in entrapment of the median nerve at wrist and elbow. J Neurol Neurosurg Psychiatry 37: 340–360PubMedGoogle Scholar
  3. 3.
    Cseuz KA, Thomas JE, Lambert EH,etal (1966) Long-term results of operation for carpal tunnel syndrome. Mayo Clin Proc 41: 232–241PubMedGoogle Scholar
  4. 4.
    Gilliat RW, Wilson TG (1953) A pneumatic-tourniquet test in the carpal tunnel syndrome. Lancet 2: 595Google Scholar
  5. 5.
    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, LondonGoogle Scholar
  6. 6.
    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: 118–121Google Scholar
  7. 7.
    Lindblom U (1974) Touch perception threshold in human glabrous skin in terms of displacement amplitude on stimulation with single mechanical pulses. Brain Res 82: 205–210PubMedGoogle Scholar
  8. 8.
    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: 750–754PubMedGoogle Scholar
  9. 9.
    Loong SC (1977) The carpal tunnel syndrome: A clinical and electophysiological study of 250 patients. Proc Aust Assoc Neurol 14: 51–62Google Scholar
  10. 10.
    Rasminsky M (1973) The effects of temperature on conduction in demyelinated single nerve fibres. Arch Neurol 28: 287–295PubMedGoogle Scholar
  11. 11.
    Richer HP, Thodes U (1977) Early electroneurographic diagnosis of carpal tunnel syndrome. EEG/EMG 8: 187–191Google Scholar
  12. 12.
    Seddon HJ (1943) Three types of nerve injury. Brain 66: 237–242Google Scholar
  13. 13.
    Stoehr M, Petruch F, Scheglmann F, Schilling K (1978) Retrograde changes of nerve fibres with the carpal tunnel syndrome. J Neurol 218: 287–291PubMedGoogle Scholar
  14. 14.
    Thomas PK (1960) Motor nerve conduction in the carpal tunnel syndrome. Neurology 10: 1045–1050PubMedGoogle Scholar
  15. 15.
    Thomas JE, Lambert EH, Cseuz KA (1967) Electrodiagnostic aspects of the carpal tunnel syndrome. Arch Neurol 16: 635–641PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1987

Authors and Affiliations

  • Helen Holmgren
    • 1
  • L. Rabow
    • 1
  1. 1.Departments of Clinical Neurophysiology and NeurosurgeryUniversity HospitalLinköpingSweden

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