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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Sonographic examination of the median nerve in patients with renal insufficiency during long-term dialysis and after renal transplantation

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  • Anne Carolus - Abteilung für Neurochirurgie, Universitätsklinikum Bochum
  • Peter Schenker - Abteilung für Allgemein- und Viszeralchirurgie, Universitätsklinikum Bochum
  • Thomas Dombert - Neurochirurgische Praxis, Dossenheim
  • Johann Fontana - Abteilung für Neurochirurgie, Universitätsklinikum Bochum
  • Kirsten Schmieder - Abteilung für Neurochirurgie, Universitätsklinikum Bochum
  • Christopher Brenke - Abteilung für Neurochirurgie, Universitätsklinikum Bochum

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMO.06.02

doi: 10.3205/15dgnc024, urn:nbn:de:0183-15dgnc0246

Published: June 2, 2015

© 2015 Carolus et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Patients with renal insufficiency are predisposed to develop carpal tunnel syndrome (CTS). Especially long-term dialysis seems to contribute to changes in median nerve texture which seems to be associated with an increased risk for CTS. The current study was designed to evaluate if these structural changes can be measured by high resolution sonography (HRS). Secondly it was the aim to proof if changes are reversible after termination of dialysis after renal transplantation.

Method: 50 patients (98 hands) were included in the study. The study population was subdivided in three groups: patients without any history of renal disease (G, n = 20), patients with long-term dialysis (D, n = 10) and patients after renal transplantation (NT, n = 20). The cross-sectional area (CSA) of the median nerve was evaluated in 2 different sections of the forearm: 12cm distal of carpal tunnel inlet (R/L12) and directly at carpal tunnel inlet (R/L0) by HRS. The ratio of both values (WFR) was built. None of the patients had any clinical symptoms for a median nerve compression syndrome. One-way ANOVA with Post-Hoc Tests (Bonferroni and Waller-Duncan Test) were used.

Results: There was no significant difference between the right and the left hand respectively. The CSA (cm2) demonstrated significantly higher values (P<0,001) in the D group (R12=6,0 ± 1,6, R0=10,3 ± 1,9, L12=7,4 ± 1,2, L0=9,7 ± 1,2) and NT group (R12=6,4 ± 2,1, R0=10,5 ± 2,1, L12=5,6 ± 1,5, L0= 9,8 ± 2,1) compared to the healthy control group G (R12=4,2 ± 1,4, R0=7,6 ± 1,5, L12=4,9 ± 1,12, L0=7,56 ± 1,8). No significant differences were detectable between the D and NT groups. According to these results there was no significant difference in the WFR.

Conclusions: Patients with chronic renal disease demonstrate significantly higher CSA values compared to their healthy counterparts. Termination of dialysis does not seem to reverse these morphological changes which might reflect an early stage of a median nerve compression syndrome.