Carpal Tunnel Syndrome: Ultrasound-Guided Carpal Tunnel Release Is Effective and Less Invasive

A new study shows the effectiveness of Ultrasound-Guided Carpal Tunnel Release in the treatment of carpal tunnel syndrome. By rapidly reducing discomfort, this alternative is also less painful than open or endoscopic surgery.

Carpal Tunnel – Image Courtesy of Bruce Blaus

Carpal Tunnel syndrome

A common problem, especially in women aged 40 to 70 carpal tunnel syndrome, involves unpleasant or painful sensations in the hand that are secondary to compression of the median nerve of the wrist. Caused by the repetition of certain hand movements, such as the use of a computer keyboard or mouse, carpal tunnel syndrome can, in the most severe cases, be treated by surgery, which essentially consists of cutting the carpal ring ligament to reduce compression of the median nerve.

In general, two surgical techniques are proposed: the oldest, called “open”, consists of freeing the carpal tunnel through the incision in the skin of the wrist and the palm about 3 cm long to cut the annular carpal ligament. For some years now, endoscopic surgery has also been offered: the surgeon makes a small incision in the flexion crease of the wrist to insert a tube that allows him, through a visualization system, to section the anterior carpal ligament.

Although less taxing than classic surgery, this technique is still invasive and in most cases requires significant recovery time.

According to a new study published in the American Journal of Roentgenology, a safe, effective, and less invasive alternative could soon provide relief to people suffering from carpal tunnel syndrome. So-called ultrasound-guided carpal tunnel release would allow for faster recovery and less post-operative discomfort.

Less invasive and less uncomfortable surgery

Developed by five researchers at Thomas Jefferson University Hospital in Philadelphia, ultrasound-guided carpal tunnel release was evaluated in patients with carpal tunnel syndrome. Sixty-one procedures were performed under local anesthesia on 25 women and 21 men with an average age of approximately 60 years.

“Patients completed three questionnaires evaluating the function and discomfort of the affected wrist immediately before the procedure, two weeks after the procedure, and at least one year after the procedure,” explains Sarah I. Kamel, the first author of the study. The median results collected show that ultrasound-guided carpal tunnel release was less painful and uncomfortable than open and endoscopic surgery, both two weeks and one year after the procedure.

In addition, no immediate postoperative complications were observed, although two patients had to be operated on for complications that occurred 8 to 10 days after the operation (one for infection after an injury and the other for post-traumatic compartment syndrome).