期刊
PAIN PHYSICIAN
卷 25, 期 1, 页码 E141-E145出版社
AM SOC INTERVENTIONAL PAIN PHYSICIANS
关键词
Ultrasound; release; carpal tunnel syndrome; needle; chronic pain; transverse carpal ligament
资金
- National Research Foundation of Korea Grant - Korean government [NRF-2021R1A2C1013073]
This study evaluated the efficacy of ultrasound-guided partial release of the transverse carpal ligament using an 18-G needle in patients with refractory carpal tunnel syndrome. The results showed that 86.2% of patients achieved successful treatment outcomes at 6 months post-treatment, with significant reduction in average NRS scores.
Background: Neuropathic pain in the hands due to carpal tunnel syndrome (CTS) disturbs sleep and affects the quality of life. Objectives: We evaluated the effect of ultrasound (US)-guided partial release of the transverse carpal ligament (TCL) using an 18-G needle in patients with refractory CTS. Study Design: A prospective outcome study. Setting: The outpatient clinic of a single academic medical center. Methods: This study was prospectively conducted. A total of 155 consecutive patients (191 wrists) with refractory chronic CTS (M:F = 28:127; age = 54.7 +/- 9.6 years; pain duration = 50.3 +/- 36.3 weeks) were enrolled and underwent US-guided partial release of the TCL using a needle. The pain severity was measured using the Numeric Rating Scale (NRS) at 3 and 6 months after the treatment. Successful treatment outcomes were defined as more than 50% reduction in the NRS score at 6 months after the treatment compared with the score at pre-treatment and NRS score < 3 at 6 months after the treatment without any surgical intervention. Results: There were 3 dropouts, and 188 wrists were included in the study. No side effects were reported. A total of 162 wrists (86.2%) showed successful treatment outcomes at 6 months after TCL release. Of the 26 wrists which had unsuccessful treatment outcomes, 6 received surgical treatment. The NRS scores at 3- and 6-month post-treatment were significantly reduced: the average NRS scores were 7.1 +/- 0.6 at baseline, 1.9 +/- 1.7 at 3 months after the treatment, and 1.7 +/- 1.7 at 6 months after the treatment. Limitations: We conducted our study without a control or a placebo group. Conclusion: We believe that US-guided partial release of the TCL using a needle can be an effective and safe technique for treating chronic refractory pain due to CTS. It can potentially be attempted before surgical treatment.
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