Turkish Neurosurgery 2017 , Vol 27 , Num 3
Comparison of Short-Term Clinical and Electrophysiological Outcomes of Local Steroid Injection and Surgical Decompression in the Treatment of Carpal Tunnel Syndrome
Ahmet Gurhan GURCAY1,Ozgur Zeliha KARAAHMET2,Oktay GURCAN1, Atilla KAZANCI1,Pinar Bora KARSLI2,Ebru Karaca UMAY2,Sevtap ACER2,Ece UNLU2,Aytul CAKCI2
1Atatürk Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey
2Diskapi Yildirim Beyazit Education and Research Hospital, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.15936-15.0 AIM: 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.

MATERIAL and 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).

CONCLUSION: 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. Keywords : Carpal tunnel syndrome, Function, Steroid injection, Surgical decompression, Symptom