Ultrasonographic Measurement of Median Nerve Cross-Sectional Area in Evaluating Carpal Tunnel Release Outcomes

Purpose Earlier research has explored carpal tunnel release (CTR) surgery outcomes using electrodiagnostic tests (EDX). However, evaluation of the median nerve before and after CTR by ultrasound (US) is understudied. This study aimed to establish the outcomes of CTR by EDX and US, and examine the correlation between the clinical improvement and US after CTR.Methods The sample consisted of 172 wrists that underwent CTR. Pain was assessed using the visual analog scale (VAS). The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ), including the symptom severity and function subscales, was applied before and 3 months after CTR. The proximal and distal cross-sectional areas (CSAs) of the median nerve were measured using US, and EDX was performed before and 3 months after CTR.Results Patients had mean preoperative and postoperative VAS scores of 7.7 +/- 1.2 and 1.7 +/- 1.2, respectively. The mean preoperative and postoperative proximal CSA measurements were 16.4 +/- 4.5 mm(2) and 12.1 +/- 3.9 mm(2), respectively. The mean preoperative and post-operative distal CSA measurements were 13.6 +/- 3.7 mm(2) and 11.0 +/- 3.1 mm(2), respectively. A significant improvement was observed in VAS, BCTQ, and EDX 3 months after CTR. A weak, positive correlation was observed between the improvement in the BCTQ symptom severity and function subscales and CSAs following CTR.Conclusions The results of this study demonstrate that preoperative median nerve CSA values may be used in evaluating CTR outcomes. (J Hand Surg Am. 2023;48(10):1060.e1-e8. Copyright (c) 2023 by the American Society for Surgery of the Hand. All rights reserved.)