Artikel
Cubital tunnel syndrome – evaluation of endoscopic-assisted decompression versus simple decompression in a single centre between 2010 and 2017
Kubitaltunnelsyndrom – Evaluation der endoskopisch-assistierten Dekompression gegenüber der einfach offenen Dekompression zwischen 2010 bis 2017
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Autoren
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Dörthe Keiner
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Sami Sharif
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Joachim Oertel
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: A retrospective analysis of patients suffering from cubital tunnel syndrome was performed comparing the surgical results of simple decompression and endoscopic-assisted decompression between 02/2010 and 05/2017.
Methods: One-hundred-and-forty-four patients were operated on cubital tunnel syndrome with open simple decompression (SD, n=55) and or endoscopic-assisted decompression (ED, n=89). Surgical data as well as clinical, electrophysiological and cosmetic outcome data was analyzed retrospectively after 3 and after 6 months. For long-term evaluation, patients were contacted again for examination of clinical symptoms and satisfaction with focus on scar-length and sensory function at the elbow.
Results: Preoperatively, 100 (69.4%) patients were McGowan grade II or III. After 3 months, data of 66 patients (74.2%) treated with ED and 42 patients (76.3%) treated with SD could be obtained. After 6 months, 52 patients (58.4%) of the ED group and 31 patients (56.4%) of the SD group had been followed up. After SD, no/residual sensory deficits were observed in 22 patients (52.4%) after 3 and in 18 (58%) patients after 6 months. Good motor function or residual motor deficit were observed in 19 (45.2%) patients after 3 months and in 20 patients (64.5%) after 6 months. After ED, no/residual sensory deficits were observed in 36 patients (54.5%) after 3 months and in 33 patients (63.5%) after 6 months. Electrophysiological results showed improvement or standard measurements in 45.2% (n=19) patients after SD and in 62.1% (n=41) following ED after 3 months. After 6 months, electrophysiological results were improved in 48.4% (n=15) of the SD patients and in 59.6% (N=31) of the ED patients. For long-term follow up, 20/55 (36.4%) patients of the SD group (mean 45 months) and 32/89 (36%) of the ED group (mean 39 months) were examined. In the long-term follow up examination, 15/20 (75%) patients were satisfied or very satisfied after SD and 30/32 (81%) after ED. Average scar length was 5 cm after SD and 2.4 cm after ED. Sensitive disability at the elbow appeared in 6/20 (30%) after SD and in 5/32 (14%) after ED.
Conclusion: In this cohort, the endoscopic-assisted technique appeared to be an equivalent technique for ulnar nerve decompression at the elbow and should be provided when possible. Permanent sensory disability at the elbow seems to occur less frequently.
