Efficacy of Ultrasound-guided Transverse Carpal Ligament Release for Carpal Tunnel Syndrome

Peking University People's Hospital60 enrolled

Overview

Carpal tunnel syndrome (CTS) is one of the most common peripheral nerve entrapment neuropathies, and it is characterized by pain, numbness, tingling, and weakness in the regions innervated by the median nerve (MN). CTS is believed to result from compression of the MN as it passes through the narrowed carpal tunnel with regard to gradual ischemia and fibrosis.Ultrasound-guided needle release of transverse carpal ligament(TCL) is an effective method to decompress the carpal.There are two main approaches to perform the release, short-axis or long-axis. However, there is no consensus about the optimal strategy.Thus, this study aimed to compare the efficacy of these two approaches for patients with mild-to-moderate CTS.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Carpal Tunnel Syndrome

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 18-80 years old * typical clinical signs of CTS present for at least three months, including pain, numbness, and tingling of the hands * positive Phalen or Tinel sign * electrophysiological parameters supportive of mild to moderate CTS * high-resolution ultrasonography demonstrated MN compression at the carpal. Exclusion Criteria: * bifid MN or bilateral CTS * pregnancy * disorders such as rheumatic immune diseases, chronic renal failure, diabetes mellitus, hypothyroidism and other systemic diseases * any accompanying disorder that could mimic CTS, such as thoracic outlet syndrome, cervical radiculopathy, polyneuropathy, proximal median nerve entrapment * history of carpal tunnel surgery or injection into the affected carpal tunnel * CTS caused by trauma, surgery, intracarpal lesions, or MN lesions malignant tumors or severe cardiorespiratory diseases

Outcomes

Primary Outcomes

visual analogue scale(VAS) scores

The VAS scores is the most common tool to assess the level of pain. Possible scores range from 0(no pain) to 10(worst possible pain).

Time frame: Baseline as well as 1 month, 3 month and 6 months after injection.

Secondary Outcomes

Boston carpal tunnel syndrome questionnaire(BCTQ)

BCTQ is the most commonly used evaluation for CTS symptoms; it contains two subscales: 11 items of symptom severity scale(SSS) and 8 items of functional status scale(FSS). Each item was scored 1-5 scores, with higher scores indicating greater severity and dysfunction.

Time frame: Baseline as well as 1 month, 3 month and 6 months after injection.

cross-sectional area(CSA) of the median nerve

CSA of the median nerve under ultrasound guidance reflects the severity of the disease to some extent

Time frame: Baseline as well as 1 month, 3 month and 6 months after injection.

Efficacy of Ultrasound-guided Transverse Carpal Ligament Release for Carpal Tunnel Syndrome

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes