Comparison of Surgical and Conservative Treatment in Carpal Tunnel Syndrome

J Korean Assoc EMG Electrodiagn Med 2004;6(2):149-155.
Published online May 10, 2004.

Abstract

Objectives: To investigate the long-term effect between surgical and conservative treatment in carpal tunnel syndrome (CTS) which is the most frequent focal entrapment neuropathy. Methods: Eighty-eight patients, one hundred four hands were enrolled. The mean age was 53.4 years old and the mean duration of follow up was 45.5 months. Patients were devided to three groups such as surgical treatment, conservative treatment, and no treatment groups. All patients were interviewed for the change of visual analog scale (VAS). The change of electrodiagnostic parameters such as onset latency, peak to peak amplitude, and conduction velocity in motor and sensory fibers of median nerve were compared. The results were analyzed according to Steven’s severity classification (mild, moderate, and severe) and the duration of follow-up. Results: Both groups, the surgical and the conservative treatment groups, showed improvements in VAS and electrophysiologic data on follow-up evaluation. Even though the surgical treatment was more effective in the severe and moderate groups (p<0.05), there was no significant difference in the mild group. According to the duration of follow-up, the effect of the surgical treatment was not significantly better than that of the conservative treatment group in the follow up period over 72 months, though it was better in the follow up period less than 72 months. Conclusion: These results suggest that the prognosis of CTS is fair. Because the prognosis of follow up period over 72 months was so good, more intensive conservative treatment would be applied to the carpal tunnel syndrome patients as a first treatment. If it is not satisfactory, then the surgical treatment could be the next treatment option.

Key Words: Carpal Tunnel Syndrome, Conservative Treatment, Surgical Treatment