Publication year: 2012
Source:World Neurosurgery
P Sarat Chandra, Pankaj Kumar Singh, Vinay Goel, Avnish Kumar Chauhan, Nirmal Thakkur, Manjari Tripathi
Objectives To compare the effects of early versus delayed endoscopic surgery in patients with moderately severe carpal tunnel syndrome (CTS). Methods The study included 100 patients with CTS. Pre-surgical investigations excluded secondary causes. Patients with moderately severe CTS (score 3 or 4), were randomized for the study. Jeremy DP bland neurophysiological grading scale for CTS was used to assess the patients. The patients underwent an endoscopic carpal tunnel release using an indigenously designed instrument. Results Treatment was offered in two groups namely, early (n=51 and <1-week post diagnosis), and delayed surgery as per the usual waiting list (n=49 and >6 months post diagnosis), subsequent to a course of conservative treatment. The improvement in both the groups was significant (P<0.001). When both the groups were compared, improvement was better for the early surgery group (P<0.001; CI=6.35 to 9.12). Conclusion On the basis of this study, we propose early endoscopic surgery in patients with moderately severe CTS.
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