Comparison of Short-Term Clinical and Electrophysiological Outcomes of Local Steroid Injection and Surgical Decompression in the Treatment of Carpal Tunnel Syndrome.
OBJECTIVE
To investigate the effectiveness of local steroid injection and surgical decompression in the treatment of patients with severe carpal tunnel syndrome (CTS) and also to compare short-term outcomes using clinical and electrophysiological criteria.


METHODS
The patients diagnosed as severe CTS were divided into two groups. Group 1 received local steroid injection and Group 2 underwent surgical decompression. The Boston Questionnaire that consists of two sections as the Boston Symptom Severity Scale (BSS) and the Functional Status Scale (FSS) was completed by the patients.


RESULTS
A total of 33 patients completed the study. Since two patients had bilateral severe CTS, a total of 35 hands were evaluated in the study. In Group 1, a significant difference was recorded between some pre- and post-treatment clinical parameters (BSS and FSS scores) and all electrophysiological parameters excluding motor conduction velocities. In Group 2, a statistically significant difference was found between pre- and post-treatment BSS scores and all electrophysiological parameters excluding motor conduction velocity and distal latency. However intergroup differences were not statistically significant as for all clinical and electrophysiological parameters (BSS, FSS, sensory amplitude, sensory conduction velocity, distal latency, motor amplitude, motor conduction velocity).


CONCLUSIONS
In the treatment of severe CTS, steroid injection and surgical decompression achieved favourable improvements in clinical and electrophysiological parameters within a short-term without superiority of one treatment over other. Therefore, in patients in whom surgical decompression can not be applied, local steroid injection can be recommended as a less invasive and a promising treatment alternative.
Atatürk Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey.
Ahmet Gurhan
AG
Gurcay
Ozgur Zeliha
OZ
Karaahmet
Oktay
O
Gurcan
Atilla
A
Kazanci
Pinar Bora
PB
Karsli
Ebru Karaca
EK
Umay
Sevtap
S
Acer
Ece
E
Unlu
Aytul
A
Cakci
D000328:Adult; D000368:Aged; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D055724:Electrophysiological Phenomena / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D013256:Steroids / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D013256:Steroids