Relationship between preoperative neuroelectrophysiological examination and postoperative muscle strength recovery in patients with moderate to severe carpal tunnel syndrome
Objective To investigate the relationship between preoperative neuroelectrophysiologi-cal examination and postoperative muscle strength recovery of abductor pollicis brevis in patients with mod-erate to severe carpal tunnel syndrome.Methods This study consecutively included 33 patients with mod-erate to severe carpal tunnel syndrome hospitalized in the Department of Orthopedics,the First Affiliated Hospital of Zhengzhou University.There were 27 cases on the bilateral sides(including the more serious side),2 cases on the right side alone,and 4 cases on the left side alone.Preoperative median nerve elec-trophysiological examination and electromyogram of abductor pollicis brevis were performed,and carpal tun-nel release was performed only.The muscle strength and function of abductor pollicis brevis were evaluated before and 6 months after the surgery.Spearman correlation analysis was used to study the correlation be-tween the distal motor latency(DML)and distal compound muscle action potential(CMAP)amplitude of median nerve and the changes of the muscle strength of abductor pollicis brevis and the thumb function after the surgery.Results The improvement rate of muscle strength,function of thumb,and numbness symp-tom was 48.48％(16/33),42.42％(14/33)and 87.88％(29/33),respectively.The correlation coeffi-cients r between preoperative median nerve DML and postoperative changes of the muscle strength of abduc-tor pollicis brevis and the thumb function were-0.230(P＞0.05),0.116(P＞0.05);the correlation coefficients r between the preoperative median nerve CMAP amplitude and postoperative changes of the muscle strength of abductor pollicis brevis and thumb function were 0.262(P＞0.05)and 0.183(P＞0.05),respectively.Conclusion Preoperative neuroelectrophysiological examination could not predict the change of muscle strength of abductor pollicis brevis and the recovery of thumb function after release in pa-tients with moderate to severe carpal tunnel syndrome,however,the surgical treatment is still an effective way to treat moderate and severe carpal tunnel syndrome.
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