title: Sonographically guided percutaneous needle release of the carpal tunnel for treatment of carpal tunnel syndrome: preliminary report.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the effectiveness of a novel treatment procedure, sonographically guided percutaneous needle release of the carpal tunnel, for individuals with carpal tunnel syndrome.
  
  
  METHODS
  Seventeen patients (89% female; mean age, 62 years; SD, 13.6 years) with a clinical diagnosis of carpal tunnel syndrome who had undergone a sonographically guided percutaneous needle release of the carpal tunnel at least 6 months before follow-up evaluation were retrospectively reviewed. At the follow-up evaluation, to ascertain previous and current symptoms as well as functional impairment, the patients filled out a hand diagram and a questionnaire. In addition, medical records were reviewed, and patients were queried regarding complications such as infection or nerve damage. Median nerve sonographic measurements and a physical evaluation were performed on a subset of 13 patients who came to the office for evaluation.
  
  
  RESULTS
  Postprocedure sonography showed that patients had a significantly smaller (P = .03) cross-sectional area of the median nerve compared to pretreatment values. In addition, patients had significantly fewer symptoms (P < .0001), less functional impairment (P = .0002), and an improved hand diagram score (P < .0001). Postprocedure patients had grip strength that was 12 lb below average (≈1 SD below) compared to grip strength norms. However, most patients (84.6%) had negative clinical diagnostic test results for carpal tunnel syndrome, and 86% said they were satisfied with the procedure. There were no procedure-related infections or nerve injuries.
  
  
  CONCLUSIONS
  Of the patients with carpal tunnel syndrome who agreed to participate in this study, most had favorable symptomatic and functional outcomes. Sonographically guided percutaneous needle release of the carpal tunnel may be an alternative option to traditional surgical treatment of carpal tunnel syndrome.
authors.affiliation: McShane Sports Medicine, 734 E Lancaster Ave, Villanova, PA 19085, USA. bjmcshane@pol.net
authors.forename: John M
authors.initials: JM
authors.lastname: McShane
authors.forename: Samantha
authors.initials: S
authors.lastname: Slaff
authors.forename: Judith E
authors.initials: JE
authors.lastname: Gold
authors.forename: Levon N
authors.initials: LN
authors.lastname: Nazarian
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009339:Needles; D020127:Recovery of Function; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional