Long-term follow-up of dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome: an analysis of 94 cases

Neurosurgery. 2009 Jan;64(1):131-7; discussion 137-8. doi: 10.1227/01.NEU.0000335784.90217.9D.

Abstract

Objective: The long-term efficacy of dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is still being debated. In this study, the authors present 94 endoscopic carpal tunnel surgery cases with long-term follow-up data.

Methods: The study includes 72 patients aged 17 to 86 years (mean age, 53.4 years); bilateral surgery was performed in 22 of these patients. Seventy-two hands of female patients and 22 hands of male patients were included. All procedures were performed with a dual-portal set according to the Chow technique. All patients were examined 2 to 3 months after surgery. The long-term follow-up evaluation was based on telephone interviews 5 to 12 years (mean, 8.2 years) after surgery.

Results: From a cohort of 214 cases that were treated surgically between 1995 and 2002, 94 cases (44%) could be evaluated for long-term follow-up. Four of these patients had to be excluded from long-term follow-up because of a switch to an open technique and early open revision (3-6 months after the first surgery), owing to persistent symptoms. A good to optimal postoperative outcome with improvement of neurological signs and subjective patient satisfaction was observed in 84 (93.3%) of the remaining 90 cases. There were no recurrences.

Conclusion: The study shows that dual-portal endoscopic release of the transverse ligament in carpal tunnel syndrome is a valuable technique that produces very good long-term results and high patient satisfaction and does not result in a significant recurrence rate.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroscopy / adverse effects
  • Arthroscopy / methods*
  • Carpal Tunnel Syndrome / complications
  • Carpal Tunnel Syndrome / surgery*
  • Collateral Ligaments / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain / epidemiology
  • Pain / etiology
  • Pain / surgery
  • Patient Satisfaction
  • Sensation Disorders / epidemiology
  • Sensation Disorders / etiology
  • Sensation Disorders / surgery
  • Treatment Outcome