Comparison of the Short-Term and Long-Term Effects of Surgery and Nonsurgical Intervention in Treating Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis.

Background

The objective of the study is to examine the short-term and long-term efficacy of surgical treatment of carpal tunnel syndrome (CTS) compared with conservative treatment (ie, splint, steroid injection, or physical therapy).

Methods

Two reviewers searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and PEDro up to September 2017. Quality appraisal and data extraction were performed in duplicate. Patient self-reported functional and symptom changes, as well as improvement of electrophysiological studies, were assessed as outcomes. Meta-analyses were performed in RevMan.

Results

From 1438 studies identified after searching, 10 remained for analysis after exclusion criteria were applied. Moderate-quality evidence indicated that surgical interventions were superior to splint or steroid injection at 6 months with a weighted mean difference of 0.25 (95% confidence interval [CI], 0.07-0.44) for functional status and 0.64 (95% CI, 0.07-1.21) for symptom severity. The surgical group had better nerve conduction outcomes at 6 months (0.57 [95% CI, 0.05-0.50] ms). No significant differences were observed at 3 or 12 months.

Conclusions

Both surgical and conservative interventions provide treatment benefits in CTS. Further studies on long-term outcome are needed.