gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Results of decompression [and transposition] of peripheral nerves in various entrapment neuropathies using a newly developed endoscopic system

Meeting Abstract

  • K. Martin - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden
  • T. Pinzer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden
  • G. Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden
  • K. Krishnan - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMO.14-01

DOI: 10.3205/09dgnc097, URN: urn:nbn:de:0183-09dgnc0976

Published: May 20, 2009

© 2009 Martin 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: The objective here is to evaluate the results obtained in 197 patients from 2000 to 2008 that underwent nerve decompression [and anterior subcutaneous transposition of the ulnar nerve] using the technique we have developed in our clinic.

Methods: Eighty nine patients with carpal tunnel syndrome (CTS), 78 with cubital tunnel syndrome (CbTS), 18 with tarsal tunnel syndrome (TTS), 8 with supinator loge syndrome (SLS) and 4 with meralgia paraesthetica (MP) (81 females and 116 males; age range 12–81 years) were treated with either endoscopic in situ nerve decompression (all of CTS, TTS, SLS and MP; 13 CbTS) or anterior subcutaneous transposition of the ulnar nerve (65 CbTS), respectively. Evaluation was according to the 9-point Bishop rating system by the physician and through a self-evaluation questionnaire by the patients. Electrophysiological studies were conducted independently by physicians specialized in these techniques. At the time of abstract submission such evaluation was available in 96 patients (40 CTS, 34 CbTS, 11 TTS, 7 SLS and 4 MP). Follow-up ranges from 6 months to 4 years.

Results: Among the 96 patients with various entrapment syndromes evaluated here, 53 (55%) showed excellent, 31 (32%) good, 8 (8%) fair, and 4 (4%) poor scores. Two patients had a relapse of CbTS after in situ decompression. One patient developed an infection 4 weeks after anterior transposition of the ulnar nerve, which was treated conservatively. One patient never improved after decompression of the lateral femoral cutaneous nerve. He is undergoing pain therapy. There were no technical complications. None of the operations had to be converted to open surgery. 63 out of 96 self-evaluations (66%) reported a considerable improvement in their quality of life after surgery; 41 (42%) reported to have returned to their previous professional activity within three weeks after surgery and only 19 patients (19%) reported that they would want to undergo a similar surgery in future.

Conclusions: After objectively evaluating the results obtained after endoscopic nerve decompression [and transposition] in this patient population we may conclude that the technique evolved by us is safe for usage in most known entrapment neuropathies, and thus could be extrapolated to other rarer syndromes.