Long-term outcome after carpal tunnel release and identification of prognostic factors

Acta Neurochir (Wien). 2019 Apr;161(4):663-671. doi: 10.1007/s00701-019-03839-y. Epub 2019 Feb 19.

Abstract

Background: The effectiveness of the surgical treatment of carpal tunnel syndrome (CTS) is well known on short term. However, limited data is available about long-term outcome after carpal tunnel release (CTR). The aims of this study were to explore the long-term outcome after CTR and to identify prognostic factors for long-term outcome.

Methods: Patients with clinically defined CTS underwent CTR and completed the Boston Carpal Tunnel Questionnaire at baseline (T0), at about 8 months (T1), and after a median follow-up of 9 years (T2), as well as a 6-point scale for perceived improvement (at T1 and T2). Potentially prognostic factors were identified by logistic regression analysis and correlation.

Results: At long-term follow-up, 87 patients (40.3%) completed the questionnaires. Mean score on Symptom Severity Scale (2.87 to 1.54; p < 0.001) and Functional Status Scale (2.14 to 1.51; p < 0.001) improved at 8 months and did not change significantly after 8 months. A favorable outcome was reported in 81.6%. A good treatment outcome after 8 months and to a lesser extent a lower FSS score at T0 were associated with a better long-term outcome.

Conclusions: CTR is a robust treatment for CTS and its effect persists after a period of 9 years. The most important factor associated with long-term outcome is treatment outcome after about 8 months and to a lesser extent functional complaints preoperatively. Outcome is independent of patient characteristics, electrodiagnostic test results, or findings at the initial neurological examination.

Keywords: Carpal tunnel release; Carpal tunnel syndrome; Long-term outcome; Prognosis.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Carpal Tunnel Syndrome / diagnosis
  • Carpal Tunnel Syndrome / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / adverse effects*
  • Neurosurgical Procedures / methods
  • Postoperative Complications / epidemiology*
  • Surveys and Questionnaires
  • Treatment Outcome