Dana Cruz MD University of Arizona College of Medicine Phoenix Background Carpal Tunnel Syndrome CTS is the most common peripheral neuropathy occurring in roughly 35 of the population Large economic burden ID: 913577
Download Presentation The PPT/PDF document "Ultrasound guided percutaneous carpal tu..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Ultrasound guided percutaneous carpal tunnel release
Dana Cruz, MD
University of Arizona College of Medicine - Phoenix
Slide2BackgroundCarpal Tunnel Syndrome (CTS) is the most common peripheral neuropathy, occurring in roughly 3-5% of the populationLarge economic burden1Surgical management involves decompression of the carpal tunnel with transection of the transverse carpal ligamentmost commonly via open or endoscopic release
1. Hubbard ZS, Law TY, Rosas S, Jernigan SC, Chim H. Economic benefit of carpal tunnel release in the Medicare patient population. Neurosurg Focus 2018; 44:E16
Slide3Ultrasound guided percutaneous carpal tunnel release
JHS 1997,
Nakamichi
& Tachibana
Described a technique of ultrasound guided percutaneous carpal tunnel release with a device consisting of an angled blade, guide, and holder, along a line midway between the median nerve and ulnar artery (safe zone) under ultrasonographic visualization
In 2015, Guo et al described an US-guided method using an abrasive thread looped percutaneously around the TCL
Slide4Technique
Slide5Technique
Slide6Technique
Slide7Technique
Slide8Technique
Slide9Technique
Slide10OutcomesArthroscopy, 201591 consecutive patients underwent ultrasonographically guided percutaneous carpal tunnel release (PCTR) Follow up average of 22.5 monthsReliable resolution of sensory disturbanceImproved cosmesis
No intraoperative or postoperative complicationsOne patient required revision surgery because of recurrent symptoms 2 years after the initial release
Slide11ConclusionsLimited clinical data is available evaluating outcomesAn initial case series of 16 patients demonstrates similar clinical outcomes after 3 months with no adverse eventsNovel, MIS techniqueRequires deep understanding of US visualizationTheoretical advantages include percutaneous performance leading to reduced postoperative sequelae and prompt return to activity
Slide12Thank You