Outcomes of a novel minimalist approach for the treatment of cubital tunnel syndrome

被引:5
作者
Lan, Zheng D. [1 ]
Tatsui, Claudio E. [1 ]
Jalali, Ali [1 ]
Humphries, William E. [1 ]
Rilea, Katheryn [1 ]
Patel, Akash [1 ]
Ehni, Bruce L. [1 ]
机构
[1] Baylor Coll Med, Dept Neurosurg, Houston, TX 77030 USA
关键词
Cubital tunnel syndrome; Minimalist approach; Ulnar neuropathy; ANTERIOR SUBCUTANEOUS TRANSPOSITION; ANTEBRACHIAL CUTANEOUS NERVE; SIMPLE DECOMPRESSION; ULNAR NEUROPATHY; ELBOW; COMPRESSION;
D O I
10.1016/j.jocn.2014.11.037
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We describe a minimalist approach to perform in situ decompression of the ulnar nerve. Our technique employs a unique small skin incision strategically placed to minimize postoperative scarring over the ulnar nerve and potentially decrease the risk of iatrogenic injury to the medial antebrachial cutaneous nerve. We retrospectively report the outcome of patients who have undergone this procedure at our institution, the Michael E. DeBakey Veterans Affairs Medical Center, from January 1 2007 through November 29 2010. All individuals underwent in situ decompression via the previously described minimalist approach. Outcome variables were Louisiana State University Medical Center (LSU) ulnar neuropathy grade, patient satisfaction, subjective improvement, complications and re-operation rate. A total of 44 procedures were performed in this cohort of 41 patients. Overall, patients' postoperative LSU grades showed a statistically significant improvement (p = 0.0019) compared to preoperative grades. Improvement of at least one grade in the LSU scale was observed in 50% of the procedures with a preoperative grade of four or less. Overall procedure satisfaction rate was 88% (39 of 44) with 70% (31 of 44) of the procedures resulting in improvement of symptoms. There were no intraoperative or postoperative complications. One patient required re-operation due to failure of neurological improvement. Our minimalistic approach to perform in situ decompression of the ulnar nerve at the cubital tunnel is both safe and effective. We observed a statistically significant improvement in LSU ulnar neuropathy grades and a success rate comparable to those reported for other more extensive surgical techniques while providing the benefit of a smaller incision, less scarring, decreased risk of iatrogenic nerve injury and minimal complications. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:964 / 968
页数:5
相关论文
共 13 条
[1]   MINIMALIST CUBITAL TUNNEL TREATMENT [J].
Abuelem, Tarek ;
Ehni, Bruce Loyal .
NEUROSURGERY, 2009, 65 (04) :A145-A149
[2]   Risk factors for ulnar nerve compression at the elbow: a case control study [J].
Bartels, R. H. M. A. ;
Verbeek, A. L. M. .
ACTA NEUROCHIRURGICA, 2007, 149 (07) :669-674
[3]   Prospective randomized controlled study comparing simple decompression versus anterior subcutaneous transposition for idiopathic neuropathy of the ulnar nerve at the elbow: Part 1 [J].
Bartels, RHMA ;
Verhagen, WIM ;
van der Wilt, GJ ;
Meulstee, J ;
van Rossum, LGM ;
Grotenhuis, JA .
NEUROSURGERY, 2005, 56 (03) :522-529
[4]   Simple decompression or anterior subcutaneous transposition for ulnar neuropathy at the elbow: A cost-minimization analysis - Part 2 [J].
Bartels, RHMA ;
Termeer, EH ;
van der Wilt, GJ ;
van Rossum, LGM ;
Meulstee, J ;
Verhagen, WIM ;
Grotenhuis, JA .
NEUROSURGERY, 2005, 56 (03) :531-535
[5]   History of the surgical treatment of ulnar nerve compression at the elbow [J].
Bartels, RHMA .
NEUROSURGERY, 2001, 49 (02) :391-399
[6]   Randomized, prospective study comparing ulnar neurolysis in situ with submuscular transposition [J].
Biggs, M ;
Curtis, JA .
NEUROSURGERY, 2006, 58 (02) :296-303
[7]   Treatment for ulnar neuropathy at the elbow [J].
Caliandro, Pietro ;
La Torre, Giuseppe ;
Padua, Roberto ;
Giannini, Fabio ;
Padua, Luca .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2011, (02)
[8]   ULNAR NEUROPATHY AT THE ELBOW - COMPARISON OF SIMPLE DECOMPRESSION AND ANTERIOR TRANSPOSITION [J].
CHAN, RC ;
PAINE, KWE ;
VARUGHESE, G .
NEUROSURGERY, 1980, 7 (06) :545-550
[9]   RESULTS OF ULNAR NEUROPATHY AT THE ELBOW TREATED BY DECOMPRESSION OR ANTERIOR TRANSPOSITION [J].
DAVIES, MA ;
VONAU, M ;
BLUM, PW ;
KWOK, BCT ;
MATHESON, JM ;
STENING, WA .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 1991, 61 (12) :929-934
[10]   INJURY TO THE MEDIAL ANTEBRACHIAL CUTANEOUS NERVE DURING CUBITAL TUNNEL SURGERY [J].
DELLON, AL ;
MACKINNON, SE .
JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME, 1985, 10B (01) :33-36