Ultrasonography and Nerve Conduction Study in patients with carpal tunnel syndrome, comparison between the two techniques before and after median nerve decompression surgery: observational study

Abstract Purpose: Traditional evaluation of suspected carpal tunnel syndrome (CTS) involves a thorough history, physical examination, and nerve conduction velocity studies (NCS). The aim of the study is to evaluate whether ultrasound (US) is a valid alternative to the emg as a routine pre-operative examination, to evaluate patients with STC, comparing some us values with NCS findings pre and postopertively Methods: Only patients with symptoms, clinical examination, and NCS findings consistent with CTS were included in the study, according to the inclusion criteria. Four ultrasonographic variables were considered in treated patients: 1) CSPA (cross sectional pisiform area); 2) S-P dt: the largest diameter of the nerve in the same point; 3) Prox Area: the section area approximately 4 cm proximal to the pisiform; 4) Prox DT: the largest diameter in the same point. Each of these values was measured pre and postoperatively (three months after surgery) As for the emgraphic variables, the VCS and the SAP were taken into consideration, that is sensitive variables. The NCS and the ultrasound values are compared In this preliminary phase of the study, 25 patients were recruited. Results: A significant correlation was found between “CSPA” and “SAP” before and after surgery, As if the CSPA could be a reliable parameter for the diagnostic evaluations of these patients, as well as for any postoperative or post-therapeutic evaluation. Conclusions: Our results indicate that high-resolution ultrasound is informative in the evaluation of CTS and shows enlargement of the median nerve at the distal wrist crease in symptomatic patients. Therefore it is a reliable modality for imaging the wrist in patients with CTS. In addition ultrasound is well tolerated and safe. The extended role of US in STC diagnosis awaits further definition, these are preliminary findings to be confirmed by further studies with larger sample size