Surgical outcome of endoscopic carpal tunnel release in elderly patients with carpal tunnel syndrome
Author(s): ,
S.-H. Park
Hallym University Kangdong Sacred Heart Hospital, Neurosurgery, Seoul, Korea, Republic of
S.-A. Nam
Hallym University Kangdong Sacred Heart Hospital, Neurosurgery, Seoul, Korea, Republic of
EANS Academy. Park S. 10/21/18; 225629; EP9002
Prof. Dr. Se-Hyuck Park
Prof. Dr. Se-Hyuck Park
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Background: Surgical outcome in the elderly with carpal tunnel syndrome(CTS) may be compromised by detrimental effect of advanced age on recovery. However, there are a few conflicting results regarding the effect of age on surgical outcome. We conducted this study to evaluate the efficacy of endoscopic carpal tunnel release(ECTR) in elderly patients.
Methods: Fom Jan. 2001 to Dec. 2016, 1341 hands in 885 patients underwent ECTR and 638 hands in 433 patients with minimal-6-month postoperative follow-up were included in this study. Patients were divided into younger group, aged under 65 years and elderly group, aged 65 years and older. Demographic data, clinical severity and electrodiagnostic abnormalities were evaluated. Surgical outcome was assessed, depending on postoperative improvement of preoperative symptoms, postoperative pillar pain and hand weakness.
Results: The younger group consisted of 387 patients(575 ECTRs) and the elderly group 46 patients(63 ECTRs). Mean age was 71.1(range 65-91) years in elderly group and 51.7(range 20-64) years in younger group. Symptom duration was slightly longer in the elderly group(44.0 mos. vs. 43.6 mos.). Operation sites(right/left/both) were compared between groups but the difference was not significant. However, the elderly group showed more severe clinical and electrophysiological findings than the younger group and there was a statistical significance between groups. The elderly group(92%) showed less clinical improvement than the younger group(95%) but the difference was not significant. Five elderly patients with poor outcome had far-advanced CTS and hand weakness with thenar atrophy didn't recovered.
Conclusions: Age might have poor effect on surgical outcome even though elderly patients showed clinical improvement after ECTRs. However, age alone is not a contraindication for carpal tunnel release in elderly patients. In addition, good outcome may not be expected in elderly patients with advanced CTS and we recommend to inform them of unpredictable outcome when obtaining consent form for surgery
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