Surgical methods of cubital tunnel syndrome treatment
Abstract
OBJECTIVE. Access different methods of surgical treatment of patients with cubital tunnel syndrome (CTS).
MATERIALS AND METHODS. Pro — and retrospective analysis of 86 patients [51 (61%) men and 32 (39%) women] with CTS at age 43,4±0.7 years was carried out. Standard decompression of the ulnar nerve was performed in 55 (64%) patients with CTS (group№ 1), 17 (20%) patients with aforementioned syndrome were surgically treated by anterior subcutaneous transposition (AST) of the ulnar nerve (group№ 2), and 14 (16%) with mini-invasive decompression (group№ 3).
RESULTS. Follow up of operated patients took place in 6 and 12 months. Results of operations was accessed by PRUNE questionnaire, nerve conduction and the amplitude of M-response obtained by electroneuromyography, degrees of motor deficit and sensory disorders immediately after surgery, in 6 and 12 months after surgical treatment. The reduction of sensitive disorders and the degree of paresis was recognized as a good result, and the reduction of only sensitive disorders as satisfactory. After 6 months, 60% of good results were observed in the first group, 47% in the second and 64% in the third.
According to intraoperative neuromonitoring, there was an increase in the M-response indices relative to the initial one by 130–220% in the group of patients with standard decompression, 43–110% in the group with anterior transposition and 138–246% in the mini-invasive group.
Increase of amplitude of M-response obtained by electroneuromyography by 5,4±0,1 millivolts (mV) was observed in patients with standard decompression, 3,2±0,1 (mV) in patients operated by AST and 5,1±0,1 by (mV) — in patients surgically treated by mini-invasive decompression in 6 months after surgery.
CONCLUSION. Mini-invasive decompression and standard decompression of the ulnar nerve are adequate methods for the surgical treatment of the cubital canal syndrome, as evidenced electrophysiologically during and after intervention using neurophysiological monitoring, as well as long-term clinical results.
About the Authors
O. V. Mukhina
Russian Medical Academy of Postgraduate Continuous Education
Russian Federation
Russian Federation
Moscow
A. V. Kuznetsov
Russian Medical Academy of Postgraduate Continuous Education
Russian Federation
Russian Federation
Moscow
O. N. Dreval
Russian Medical Academy of Postgraduate Continuous Education
Russian Federation
Russian Federation
Moscow
A. G. Fedyakov
City Clinical Hospital named after S. P. Botkin
Russian Federation
Russian Federation
Moscow
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For citations:
Mukhina O.V., Kuznetsov A.V., Dreval O.N., Fedyakov A.G. Surgical methods of cubital tunnel syndrome treatment. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2019;11(1):48-52. (In Russ.)
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