Analysis Of Carpal Tunnel Syndrome Postoperative Morphological Changes Of Medium Nerve

Background:There are few data related to Morphological changes of the medium nerve after the open carpal tunnel release and the Morphological changes in the role of indicators for postoperative evaluation.Objective:We measured the median nerve parameters before-and-after the open carpal tunnel release(OCTR)by means of ultrasonic and magnetic resonance(MR)to analysis the statistic correlation between these data and early postoperative performance in carpal tunnel syndrome(CTS)patients.Method: Totally 46 CTS were scanned by ultrasonic and MR from every pisiform bone,hamulus of hamate bone transverse plane on before and post operation.We measured the antero-posterior,transverse diameters and area of the cross-sectional plane of the median nerve,and calculated the swelling and flattening ratio on inlet and outlet sections of the carpal tunnel as well as the changes in data values.the early treatment outcomes at postoperative month 3 were evaluated.Then the grades and above calculated classification data were analysed by using the pearson coefficient respectively.Results:High-frequency ultrasound data: median nerve cross-sectional area at the inlet plane reduced(0.196 ± 0.155)%,swelling rate reduced(0.211 ± 0.131)% postoperatively.At the outlet plane the median nerve cross-sectional area is reduced(0.086 ± 0.241)%,swelling rate reduced(0.733 ± 0.096)%,flattening rate reduced(0.122 ± 0.082)% after surgery.MRI data: After surgery at inlet median nerve cross-sectional area reduced(0.142 ± 0.190)%,swelling rate reduce(0.233 ± 0.285)%;the outlet carpal tunnel cross-sectional area reduced(0.087 ± 0.256)%,swelling rate reduced(0.052 ± 0.271)%,flattening rate reduced(0.760 ± 0.544)%.Conclusions:There was statistically significant differences in inlet and outlet plane between preoperative and postoperative one.(p<0.05).The postoperative alterations of cross-sectional area and swelling ratio at carpal tunnel entrance plane correlated positively with early outcomes.This finding indicate morphological changes of the medium nerve could be utilized to access therapeutic effect of OCTR validly.The cross-sectional area and swelling ratio at the inlet plane of the carpal tunnel would be worth to predict the early outcome after OCTR.