내시경적 수근관절개술의 임상결과

Abstract

Carpal tunnel syndrome (CTS) is the most frequently encountered peripheral nerve entrapment syndrome. Surgical treatments consist of conventional open technique, alternative technique using retinaculatome, and endoscopic surgery. Endoscopic carpal tunnel release (ECTR) has been developed as a minimally invasice method, alternative to the open procedure over the past decade. The author presented surgical outcome of ECTR. Fifty cases (19 right, 17 left and 7 bilateral hands) in 43 consecutive patients (mean age: 52.4 years, range: 35-69 years) with electrodiagnostically-proven CTS underwent a Brown’s two-portal ECTR from July 2001 to August 2004. Preoperative clinical findings and results of electrodiagnostic studies were compared with surgical outcome after three-month-follow-up period. Among 50 cases, 47 (94%) were satisfied with complete or significant relief or symptoms after ECTR and 3 (6%) were dissatisfied with partial or no relief of symptoms. No major complications were observed. Severity of electrodiagmostic abnormalities tended to be correlated with surgical outcome. however, this did not reach to statistical significance. Severity of clinical findings, age at onset and symptom duration were not correlated with surgical outcome. ECTR is effective in relieving symptoms of CTS with a low complication rate after the learning curve period. Thus, ECTR can be the first procedure and alternative to the open surgery for CTS.