Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort
Objectives: To assess the natural history for development of carpal tunnel syndrome (CTS) in persons with acute spinal cord injury (SCI) at 1 year postdischarge from initial rehabilitation and to assess baseline median nerve (MN) cross-sectional area (CSA) above/below 10 mm2 correlates with any long...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Archives of Rehabilitation Research and Clinical Translation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109522000702 |
| _version_ | 1797987251335987200 |
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| author | Minh Quan T. Le, MD Elizabeth R. Felix, PhD Robert Irwin, MD Diana D. Cardenas, MD Rachel E. Cowan, PhD |
| author_facet | Minh Quan T. Le, MD Elizabeth R. Felix, PhD Robert Irwin, MD Diana D. Cardenas, MD Rachel E. Cowan, PhD |
| author_sort | Minh Quan T. Le, MD |
| collection | DOAJ |
| description | Objectives: To assess the natural history for development of carpal tunnel syndrome (CTS) in persons with acute spinal cord injury (SCI) at 1 year postdischarge from initial rehabilitation and to assess baseline median nerve (MN) cross-sectional area (CSA) above/below 10 mm2 correlates with any longitudinal changes in quantitative ultrasound (US) of the MN. Design: A prospective cohort study of persons with acute SCI evaluated for CTS using quantitative US and compared to a group without SCI (non-SCI). Setting: Academic medical center. Participants: N=69 total (N=34 SCI, N=35 non-SCI). The average age in both groups was 28 and the SCI group included 30 males and 2 females and the non-SCI group included 30 males and 3 females. Interventions: Not applicable. Main Outcome Measures: The primary outcome was the change in quantitative US parameters of the MN, including CSA and grayscale, from baseline to 1-year follow-up in those with SCI and those without SCI. CTS symptomatology and physical exam sum score and US measures for dominant and nondominant arms were considered secondary outcomes. Results: The SCI had darker nerves at baseline (P=.036, nondominant), greater CTS symptoms at follow-up (P≤.036, bilateral), and no differences in all change scores (all P≥.056). Individuals with smaller nerves at baseline had larger increases in nerve size (P=.029, nondominant) vs those with larger nerves. Change in CTS symptoms CSA (nondominant) and nerve echogenicity (dominant) were inversely associated with their respective baseline values (all P≤.045). Conclusions: We observed few differences between the SCI group and the non-SCI control group and between those with smaller vs larger MN. In general, MN pathology changes (CTS symptoms and US variables) over 1 year were more common in the nondominant arm and appear to be a function of MN pathology at enrollment. Individuals with SCI may experience increased CTS symptoms as soon as 1 year after injury. |
| first_indexed | 2024-04-11T07:45:53Z |
| format | Article |
| id | doaj.art-2a11b58845454cf9a27bd53c72096ec6 |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-04-11T07:45:53Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-2a11b58845454cf9a27bd53c72096ec62022-12-22T04:36:18ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952022-12-0144100238Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled CohortMinh Quan T. Le, MD0Elizabeth R. Felix, PhD1Robert Irwin, MD2Diana D. Cardenas, MD3Rachel E. Cowan, PhD4Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL; Corresponding author Minh Quan Le, MD, Jackson Memorial Hospital, 10140 Ramblewood Dr, Coral Springs, FL 33071.South Florida SCI Model System, Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FL; Department of Physical Medicine and Rehabilitation, Miami Veterans Administration Medical Center, Miami, FLSouth Florida SCI Model System, Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FLSouth Florida SCI Model System, Department of Physical Medicine & Rehabilitation, University of Miami Miller School of Medicine, Miami, FLDepartment of Physical Medicine & Rehabilitation, University of Alabama at Birmingham, Birmingham, AL; The Miami Project to Cure Paralysis, Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FLObjectives: To assess the natural history for development of carpal tunnel syndrome (CTS) in persons with acute spinal cord injury (SCI) at 1 year postdischarge from initial rehabilitation and to assess baseline median nerve (MN) cross-sectional area (CSA) above/below 10 mm2 correlates with any longitudinal changes in quantitative ultrasound (US) of the MN. Design: A prospective cohort study of persons with acute SCI evaluated for CTS using quantitative US and compared to a group without SCI (non-SCI). Setting: Academic medical center. Participants: N=69 total (N=34 SCI, N=35 non-SCI). The average age in both groups was 28 and the SCI group included 30 males and 2 females and the non-SCI group included 30 males and 3 females. Interventions: Not applicable. Main Outcome Measures: The primary outcome was the change in quantitative US parameters of the MN, including CSA and grayscale, from baseline to 1-year follow-up in those with SCI and those without SCI. CTS symptomatology and physical exam sum score and US measures for dominant and nondominant arms were considered secondary outcomes. Results: The SCI had darker nerves at baseline (P=.036, nondominant), greater CTS symptoms at follow-up (P≤.036, bilateral), and no differences in all change scores (all P≥.056). Individuals with smaller nerves at baseline had larger increases in nerve size (P=.029, nondominant) vs those with larger nerves. Change in CTS symptoms CSA (nondominant) and nerve echogenicity (dominant) were inversely associated with their respective baseline values (all P≤.045). Conclusions: We observed few differences between the SCI group and the non-SCI control group and between those with smaller vs larger MN. In general, MN pathology changes (CTS symptoms and US variables) over 1 year were more common in the nondominant arm and appear to be a function of MN pathology at enrollment. Individuals with SCI may experience increased CTS symptoms as soon as 1 year after injury.http://www.sciencedirect.com/science/article/pii/S2590109522000702UltrasonographySpinal cord InjuriesCarpal tunnel syndromeMedian nerveRehabilitation |
| spellingShingle | Minh Quan T. Le, MD Elizabeth R. Felix, PhD Robert Irwin, MD Diana D. Cardenas, MD Rachel E. Cowan, PhD Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort Archives of Rehabilitation Research and Clinical Translation Ultrasonography Spinal cord Injuries Carpal tunnel syndrome Median nerve Rehabilitation |
| title | Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort |
| title_full | Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort |
| title_fullStr | Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort |
| title_full_unstemmed | Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort |
| title_short | Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort |
| title_sort | longitudinal median nerve ultrasound changes in individuals with spinal cord injury and an age and sex matched nondisabled cohort |
| topic | Ultrasonography Spinal cord Injuries Carpal tunnel syndrome Median nerve Rehabilitation |
| url | http://www.sciencedirect.com/science/article/pii/S2590109522000702 |
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