Modern aspects of surgical treatment of patients with carpal tunnel syndrome: endoscopic assistance vs open decompression

SUMMARY. The aim of the study — a comparative assessment of the effectiveness of surgical treatment of patients with carpal tunnel syndrome using open decompression and median nerve decompression with endoscopic assistance.

MATERIALS AND METHODS. The article analyzes the results of surgical treatment of patients with carpal tunnel syndrome who underwent surgical treatment from 2011 to 2021. All patients were divided into two groups. Median nerve decompression with endoscopic assistance (Group 1) was performed in 31 women and 3 men (mean age — 57.12±2.86 years) in N.N. Burdenko National Scientific and Practical Center for Neurosurgery. Open decompression (Group 2) was carried out in 5 men and 35 women (mean age — 59.88±2.99 years) in the Clinical Center of the Sechenov First Moscow State Medical University. The results of surgical treatment were evaluated using Visual Analogue Scale (VAS; from 0 to 10 points), and Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the Boston Carpal Tunnel Questionnaire before surgery, at discharge and 1 year after the surgery. Statistical data were processed using Microsoft Excel 2013 (Microsoft Corp., USA) and Statistica 10 software package (StatSoft Inc., USA).

RESULTS. A statistically significant decrease in the severity of pain syndrome at discharge were registered both in the Group 1 (p <0.001) and in the Group 2 (p<0.05). No statistically significant differences by gender were found. Also, positive dynamics was registered for the Symptom Severity Scale and Functional Status Scale, which was the more pronounced in Group 1.

CONCLUSION. Surgical treatment of carpal tunnel syndrome (open decompression, single-portal decompression with endoscopic assistance) is an effective treatment method contributing to the return of the patients to normal work activity. The results of the study indicate rather more effectiveness of the endoscopic technique in the early postoperative period in terms of more pronounced decrease of pain syndrome and shortening of postoperative rehabilitation period.

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