Changes of the 6-item CTS symptoms scale and the nerve electrophysiological findings after surgery for carpal tunnel syndrome with abnormal nerve electrophysiological findings

Abstract

Background: The aim of this study was to compare the Six-Item CTS Symptoms Scale (CTS-6) and nerve electrophysiological findings between pre- and the postoperative states of patients with carpal tunnel syndrome (CTS) who were treated by carpal tunnel release. Methods: The preoperative and postoperative CTS-6 and nerve electrophysiological findings were evaluated in a total of 60 cases treated for CTS. Preoperative nerve electrophysiological study determined the presence of CTS and the postoperative analysis was performed at a mean 3.75 years after intervention. Poor prognostic factors and preoperative nerve electrophysiological findings influencing the recovery periods were evaluated. Results: As compared with the preoperative score, the average CTS-6 at the latest follow-up improved from 3.21 ± 0.66 to 1.86 ± 0.72 (P < 0.001) in 53 out of 60 cases (88%). Likewise, the nerve electrophysiological findings based on Bland grade system improved significantly from 2.23 ± 1.16 to 1.86 ± 0.72 (P < 0.001). There were statistically significant differences seen between the improved values of CTS-6 and Bland grade (P = 0.048). The conduction velocity of the sensory nerve was improved from 36.58 ± 6.47 m/sec to 39.20 ± 1.10 m/sec (P < 0.01), and the distal latency of the motor nerve improved from 4.03 ± 1.40 to 3.67 ± 1.10 (P = 0.038). In electrophysiological findings, the recovery period of the isolated CTS was relatively shorter compared to CTS combined with cervical radiculopathy (P = 0.049). Conclusion: The outcome of surgery for CTS was excellent in most cases. The CTS-6 was a very reliable, valuable and useful indicator for the treatment outcome. There was a statistically significant difference between the CTS-6 and Bland grade. Our data shows that for CTS patients with combined cervical radiculopathy, recovery period after CTS surgery may be negatively impacted.