Associations of Preoperative Ultrasonography, Nerve Conduction Studies, and CTS-6 to Boston Carpal Tunnel Questionnaires Up to One Year Following Carpal Tunnel Release.

PURPOSE: The purpose of this study was to evaluate the association between preoperative ultrasound, nerve conduction studies (NCS), and/or carpal tunnel syndrome-6 (CTS-6) scores and the postoperative courses of patients undergoing carpal tunnel release (CTR).

METHODS

This was a retrospective study of all patients indicated for CTR at a single institution between October 2014 and August 2021. Preoperative data, including age, sex, body mass index, and laterality of the involved hand(s), were collected. Ultrasound was performed with a median nerve cross-sectional area (CSA) of ≥10 mm2 considered positive for CTS. Nerve conduction studies evaluated the distal sensory and motor latencies of the median nerve. Carpal tunnel syndrome-6 scores ≥12 were considered positive for CTS. The primary outcome measurement was the Boston Carpal Tunnel Questionnaire (BCTQ). Statistical analysis was performed to assess the correlation of preoperative studies to predict changes in postoperative BCTQ scores following CTR. Statistical significance was set to P < .05.

RESULTS

In total, 106 patients were included in the analysis, of which 69 patients were positive for CTS on US with an average median nerve CSA of 15.2 ± 4.4 mm2, whereas 37 patients were negative with an average CSA of 9.0 ± 1.3 mm2 (P < .001). Female sex, height, and weight were significantly different between the CTS-positive and -negative cohorts (P = .01, P = .02, and P = .01). Preoperative US, NCS, and CTS-6 were not associated with the ability to achieve minimal clinically important difference in change in BCTQ scores after surgery.

CONCLUSIONS

Although helpful in establishing a diagnosis of CTS, positive findings on preoperative US, NCS, and CTS-6 alone are not associated with clinically significant changes in BCTQ symptom or function scores up to 1 year after surgery following CTR.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.