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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

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The endoscopic technique for cubital syndrome – is it useful in (sub-)luxating ulnar nerve?

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  • C. Heinen - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • R. König - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • M. Pedro - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • T. Kretschmer - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • H.-P. Richter - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • G. Antoniadis - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg
  • R. Wirtz - Neurochirurgische Klinik der Universität Ulm am BKH zu Günzburg

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. DocP15-07

doi: 10.3205/09dgnc416, urn:nbn:de:0183-09dgnc4161

Published: May 20, 2009

© 2009 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: The treatment of cubital tunnel syndrome (CubTS) is still controversially discussed. Endoscopic long-distance decompression has recently been introduced and since then has shown promising results. Its role when dealing with (sub-)luxation of the ulnar nerve has not yet been elucidated. We present our experience with the endoscopic technique with special regard to the patients suffering from ulnar nerve (sub-)luxation.

Methods: 41 patients with CubTS treated endoscopically were followed over 13 months on average (median 13 months). 36 were male, 5 female. In 17 cases the right side, and in 34 cases the left side was affected. Overall, 6 had mild (Dellon I), 23 moderate (Dellon II), and 12 severe (Dellon III) symptoms. 4 presented with a (sub-)luxating ulnar nerve. We did the operations according to Hoffmann’s technique using a commercially available endoscopic system and instruments.

Results: 31 patients achieved very good results (Bishop scale I), 2 good (Bishop II), 6 fair (Bishop III), and 2 bad results (Bishop IV), respectively. The mean decompression distance was about 14 cm. In all patients with (sub-)luxating nerve Bishop grade I could be achieved, and so far none of them required secondary surgery. Nonetheless, one patient (with a previously not luxating nerve) underwent submuscular transposition 15 months after endoscopic decompression due to recurrent symptoms.

Conclusions: In our initial experience endoscopic release of the ulnar nerve in CubTS is a safe and feasible technique leading to good and very good results (33/41). Seemingly even (sub‑)luxating nerves can be released in this manner without a higher risk of further operations. Restrictions apply due to limited follow-up periods. Of course, further and larger studies have to clarify this issue.