gms | German Medical Science

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

Proposal of a new grading system in sulcus ulnaris syndrome based on a 10-year follow-up

Vorstellung eines neuen Grading-Systems für das Sulcus-ulnaris-Syndrom auf der Grundlage eines 10-Jahres-Follow-up

Meeting Abstract

Suche in Medline nach

  • corresponding author Andreas M. Frank - Neurochirurgische Klinik und Poliklinik der TU München, Klinikum rechts der Isar, München
  • A. Clapos - Neurochirurgische Klinik und Poliklinik der TU München, Klinikum rechts der Isar, München
  • A. E. Trappe - Neurochirurgische Klinik und Poliklinik der TU München, Klinikum rechts der Isar, München

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. DocP 13.142

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2004/04dgnc0426.shtml

Veröffentlicht: 23. April 2004

© 2004 Frank et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Treatment of sulcus-ulnaris-syndrome (SUS) has been discussed controversially during the past decades. Some authors proposed transposition of the nerve as mandatory, while others stated that microsurgical decompression alone has favorable results. For clinical assessment the Mc Gowan scale which includes only three clinical grades without implication of electrophysiologic data was widely used. However no larger series of long time results have been published recently.

Methods

We conducted a follow-up study of 29 patients on whom 32 microsurgical decompressions of the sulcus ulnaris nerve were performed. All patients (mean age 54 ys, ranking from 28-74 ys) underwent a clinical follow-up 10 years after surgery (10 ys, SD±4,33 ys.) on the average. Duration of symptoms preoperatively, grade of symptoms according to Mc Gowan and results were assessed. A new grading scale including electrophysiologic data was also applied pre- and postoperatively.

Results

Preoperatively 0% presented without complaints (postop 50%),34% grade 1 (post 28%), 50% grade 2 (post 22%), 16% grade 3 (post 0%). In our grading scale, which includes 5 grades, 0% were without complaints (post 50%), grade 1 9%, (post 12%), grade 2 28%, (post 19%), grade 3 47%, (post 19%), grade 4 13 %, (post 0%), grade 5 3%, (post 0%). Statistical evaluation proved that postoperativ results were statistically significant (p<0,001). Results were not dependent on (I)age of patients, (II) duration of symptoms preoperativ. There was statistical evidence that operative results were dependent on the preoperative grade. Outcome was better according to Mc Gowan in 56% by one grade, 22% by two grades, 1% by three grades, unchanged in 17%, worse in 1%. According to our scale 19% one grade, 31% two grades, 25% three grades, 3% four grades, 17% unchanged, 3% worse one grade, 3% worse two grades. However, subjective ratings were 86% better, 11% unchanged, 3% worse.

Conclusions

Our data show that grading of SUS should include electrophysiologic findings for better discrimination of the severity of illness. Microsurgical decompression is the therapy of choice and has good long-term results. Our data also show that long-term success of operation is better the earlier an operation is performed. Volar transposition should be restricted to special cases.