Comparison of the Clinical Effectiveness of Ultrasound-Guided Corticosteroid Injection with and without Needle Release of the Transverse Carpal Ligament in Carpal Tunnel Syndrome

2017 ◽  
Vol 78 (1-2) ◽  
pp. 33-40 ◽  
Author(s):  
Xuan-Yan Guo ◽  
Mao-xiang Xiong ◽  
Yu Zhao ◽  
Fan-Ding He ◽  
Xue-Qing Cheng ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Clinical Effectiveness ◽  
Transverse Carpal Ligament ◽  
Ultrasound Guided ◽  
Tunnel Syndrome

scholarly journals Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Fu-An Yang ◽  
Ya-Chu Shih ◽  
Jia-Pei Hong ◽  
Chin-Wen Wu ◽  
Chun-De Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Randomized Controlled Trials ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Tunnel Syndrome

Abstract Carpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. Randomized controlled trials (RCTs) were identified, and data collection was completed on 7 October 7, 2020. Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD = −0.49, 95% CI (−0.74, −0.25), P < 0.0001], Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD = −0.24, 95% CI (−0.42, −0.06), P = 0.01], distal motor latency [SMD = −0.36, 95% CI (−0.70, −0.02), P = 0.04], and compound muscle action potential [SMD = 0.38, 95% CI (0.16, 0.61), P = 0.0008] . Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

scholarly journals OUR EXPERIENCE IN CARPAL TUNNEL SYNDROME THERAPEUTIC EFFECTIVENESS EVALUATION

2019 ◽  
Vol 7 ◽  
pp. 833-838
Author(s):  
Jolanta Umure ◽  
Ināra Logina ◽  
Marija Mihailova
Keyword(s):  
Neuropathic Pain ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Motor Nerve ◽  
Clinical Effectiveness ◽  
University Hospital ◽  
Compression Tests ◽  
Neurophysiological Studies ◽  
Tunnel Syndrome

Objectives: Analyze the literature data on the incidence and manifestation of carpal tunnel syndrome (CTS), as well as the pathogenesis and treatment options. Perform a specially designed, validated test - Pain Detection. Evaluate the objective state of patients with CTS - sensory impairment, compression test. Assess patients’ neurologic and neurophysiologic data before and after the blockade and evaluate its effectiveness. Perform a specially designed, validated test - Patients` Global Impression of Change scale (PGIC) one month after corticosteroid injection (CSI).Methods and Materials: The study includes an analysis of 55 arms of patients of different age with mild and moderate CTS who came for a neurological examination at the Neurology Outpatient Department of the Pauls Stradiņš Clinical University Hospital during the period of 01.08.2018 – 01.01.2019. All patients were analyzed clinically and neurophysiologically before CSI and one month after CSI. A Pain Detect scale, PGIC scale, compression tests and sensory tests were used for the evaluation of clinical symptom. A median nerve sensory and motor nerve conduction study was performed.Results: According to the Pain Detect scale, 60% of patients showed neuropathic pain before CSI, and 78% of patients presented clinical effectiveness after CSI. 98% of patients present clinical effectiveness after CSI in the PGIC scale. 85% of patients had improvement in neurophysiological studies – motor distal latency decreased after CSI. Before CSI, the average motor distal latency was 5.7ms (range 4.5-12.9ms SD±1.5), which was on average 130% from the maximal norm (range 102- 293 SD±36). After the CSI, the average motor distal latency was 5.2ms (range 3.8-10.7ms SD±1.3), which was on average 120% from the maximal norm (range 88-243 SD±30). We didn’t find any significant correlation between the improvement of the patient's clinical condition and the improvement of electrophysiological outcomes.Conclusions: The study concludes that the Pain Detect sensitivity for neuropathic pain evaluation of patients with CTS is 60%. Patients show clinical and neurophysiological improvement after CSI, but there is no correlation between neurophysiological and clinical improvement. The study concludes that the PGIC scale can be used to quickly assess the effectiveness of therapy.

scholarly journals Ultrasound-Guided Corticosteroid Injection in Carpal Tunnel Syndrome: Comparison Between Radial and Ulnar Approaches

2020 ◽  
Vol Volume 13 ◽  
pp. 1569-1578
Author(s):  
Arash Babaei-Ghazani ◽  
Bijan Forogh ◽  
Gholam Reza Raissi ◽  
Tannaz Ahadi ◽  
Bina Eftekharsadat ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Tunnel Syndrome

scholarly journals Ultrasound-guided corticosteroid injection for patients with carpal tunnel syndrome: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fu-An Yang ◽  
Ya-Chu Shih ◽  
Jia-Pei Hong ◽  
Chin-Wen Wu ◽  
Chun-De Liao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Carpal Tunnel Syndrome ◽  
Randomized Controlled Trials ◽  
Carpal Tunnel ◽  
Corticosteroid Injection ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Tunnel Syndrome

AbstractCarpal tunnel syndrome (CTS) refers to the symptoms and signs caused by the compression of the median nerve in the carpal tunnel. It can be treated by corticosteroid injection into the carpal tunnel. Two methods for injection have been employed, namely ultrasound-guided and landmark-guided injection. This systematic review and meta-analysis was conducted to compare these methods in terms of several outcomes. A search of the PubMed, Cochrane Library, and Embase databases was performed from the date of their inception to October 7, 2020 to identify randomized controlled trials (RCTs). Results for continuous variables are expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. The analysis included eight RCTs published between 2013 and 2019 with a total of 448 patients. Ultrasound-guided injection yielded more favorable results than landmark-guided injection for the Boston Carpal Tunnel Syndrome Questionnaire, Symptom Severity Scale [SMD =  − 0.43, 95% CI (− 0.68, − 0.19), P = 0.0005] and Boston Carpal Tunnel Syndrome Questionnaire, Functional Status Scale [SMD =  − 0.50, 95% CI (− 0.84, − 0.15), P = 0.005]. Ultrasound-guided corticosteroid injection is recommended for patients with CTS.

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