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55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

25. bis 28.04.2004, Köln

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Is the endoscopic carpal tunnel release contraindicated for older patients at the age of over 80 years?

Stellt ein Patientenalter über 80 Jahre eine Kontraindikation zur endoskopischen Behandlung des Karpaltunnelsyndroms dar?

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  • corresponding author Christian Peter Giuliano Heinen - Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg
  • T. Kretschmer - Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg
  • K. Mohr - Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg
  • H.-P. Richter - Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg
  • G. Antoniadis - Neurochirurgische Klinik der Universität Ulm am Bezirkskrankenhaus Günzburg, Günzburg

Deutsche Gesellschaft für Neurochirurgie. Ungarische Gesellschaft für Neurochirurgie. 55. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 1. Joint Meeting mit der Ungarischen Gesellschaft für Neurochirurgie. Köln, 25.-28.04.2004. Düsseldorf, Köln: German Medical Science; 2004. DocMO.08.09

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2004/04dgnc0088.shtml

Published: April 23, 2004

© 2004 Heinen et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

Since 1987 endoscopic technique has been used for the treatment of carpal tunnel syndrome. The aim of this study is to examine the practicality of endoscopic monoportal technique in geriatric patients over 80 years of age.

Methods

From December 1994 to November 2003, 1534 patients underwent endoscopic carpal tunnel release in our department. Seventy-five patients were over 80 years of age; 16 out of 75 patients were treated in the first period (1995-1998) -Group I- and 59 during the second period (1999-2003) -Group II. The predominant clinical symptom was nocturnal pain and numbness (92%), followed by paresthesia of fingers I-III (88%) and impaired motor function as well as tactile gnosia of the affected hand. Positive Phalen´s maneuver was observed in 61.3% and Tinel´s sign in 57.3% of the patients. A total of 11 patients (14.7%) showed a complete electrophysiological conduction block.

Results

We experienced intraoperative difficulties with endoscope insertion into the carpal tunnel in 25.8% in Group I, but only in 9.6% in Group II. Such intraoperative problems were mainly due to synovitis or degenerative stenosis of the carpal tunnel (9 Patients). In only 6 out of 9 patients did endoscopic surgery need to be converted into an open decompression during the same session. No complications were observed.

Conclusions

Endoscopic carpal tunnel surgery according to AGEE monoportal technique represents a suitable minimally invasive technique for decompression of median nerve in patients over 80 years of age, even in the presence of advanced defects, especially when carried out by experienced surgeons. Endoscopic procedure can therefore be recommended to patients over 80 years of age.