Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome
Abstract Background Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) N...
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| Format: | Article |
| Language: | English |
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BMC
2021-10-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-021-04771-y |
| _version_ | 1818937147385708544 |
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| author | Masato Ise Taichi Saito Yoshimi Katayama Ryuichi Nakahara Yasunori Shimamura Masanori Hamada Masuo Senda Toshifumi Ozaki |
| author_facet | Masato Ise Taichi Saito Yoshimi Katayama Ryuichi Nakahara Yasunori Shimamura Masanori Hamada Masuo Senda Toshifumi Ozaki |
| author_sort | Masato Ise |
| collection | DOAJ |
| description | Abstract Background Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS. Method Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement. Results The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, r = 0.67; 0–12 months, r = 0.60) and DASH (0–12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, r = − 0.33; 0–12 months, r = − 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below. Conclusion NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS. |
| first_indexed | 2024-12-20T05:47:20Z |
| format | Article |
| id | doaj.art-18099e1e14ab414cb68406652efbf4e5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-20T05:47:20Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-18099e1e14ab414cb68406652efbf4e52022-12-21T19:51:15ZengBMCBMC Musculoskeletal Disorders1471-24742021-10-012211910.1186/s12891-021-04771-yRelationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndromeMasato Ise0Taichi Saito1Yoshimi Katayama2Ryuichi Nakahara3Yasunori Shimamura4Masanori Hamada5Masuo Senda6Toshifumi Ozaki7Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Rehabilitation Medicine, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Sports Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesDepartment of Rehabilitation Medicine, Okayama University HospitalDepartment of Rehabilitation Medicine, Okayama University HospitalDepartment of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesAbstract Background Nerve conduction study (NCS) is the only useful test for objective assessment of carpal tunnel syndrome (CTS). However, the relationship between pre- and postoperative NCS and clinical outcomes was unclear. This study aimed to determine whether pre- and postoperative (6 months) NCS could predict patient-oriented and motor outcomes (6 and 12 months postoperatively) in patients with CTS. Method Of the 85 patients with CTS, 107 hands were analyzed from March 2011 to March 2020. All patients underwent open carpal tunnel release and were examined using the disabilities of the arm, shoulder and hand (DASH) questionnaire and grip strength (GS) preoperatively and 6 and 12 months postoperatively. Moreover, NCS was examined preoperatively and 6 months postoperatively. Distal motor latency (DML) and sensory conduction velocity (SCV) were the parameters used for NCS. The correlation coefficient between NCS and DASH or GS was calculated. A receiver operating characteristic curve was utilized to determine the NCS threshold value to predict DASH and GS improvement. Results The average scores of GS preoperatively and 6 and 12 months postoperatively were 21.3, 22.3, and 22.8, respectively. On the other hand, the average scores of DASH preoperatively and 6 and 12 months postoperatively were 28.8, 18.3, and 12.2, respectively. The average NCS scores (DML and SCV) preoperatively/6 months postoperatively were 7.3/5.4 and 27.8/36.7, respectively. Preoperative NCS did not correlate with DASH and GS. Postoperative SCV correlated with the change in grip strength (6–12 months, r = 0.67; 0–12 months, r = 0.60) and DASH (0–12 months, r = 0.77). Moreover, postoperative DML correlated with the change in DASH (6–12 months, r = − 0.33; 0–12 months, r = − 0.59). The prediction for the improvement of GS/DASH achieved a sensitivity of 50.0%/66.7% and a specificity of 100%/100%, at an SCV cutoff score of 38.5/45.0 or above. The prediction for improvement of GS/DASH achieved a sensitivity of 83.3%/66.7% and a specificity of 100%/66.7% at a DML cutoff score of 4.4/4.4 or below. Conclusion NCS at 6 months postoperatively can be used to predict the improvement of clinical outcome after 6 months postoperatively in patients with CTS.https://doi.org/10.1186/s12891-021-04771-yCarpal tunnel syndromeNerve conduction studyThe disability of the arm, shoulder and hand questionnaireClinical outcomes |
| spellingShingle | Masato Ise Taichi Saito Yoshimi Katayama Ryuichi Nakahara Yasunori Shimamura Masanori Hamada Masuo Senda Toshifumi Ozaki Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome BMC Musculoskeletal Disorders Carpal tunnel syndrome Nerve conduction study The disability of the arm, shoulder and hand questionnaire Clinical outcomes |
| title | Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| title_full | Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| title_fullStr | Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| title_full_unstemmed | Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| title_short | Relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| title_sort | relationship between clinical outcomes and nerve conduction studies before and after surgery in patients with carpal tunnel syndrome |
| topic | Carpal tunnel syndrome Nerve conduction study The disability of the arm, shoulder and hand questionnaire Clinical outcomes |
| url | https://doi.org/10.1186/s12891-021-04771-y |
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