Ultrasound-guided needle knife release of the transverse carpal ligament for carpal tunnel syndrome: a prospective case series study.
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper limb and seriously affects patients' quality of life. Ultrasound-guided percutaneous release has emerged as a minimally invasive alternative to conventional surgery. This prospective case series aimed to evaluate the clinical efficacy and safety of ultrasound-guided needle knife release of the transverse carpal ligament in patients with CTS.
Eighteen patients diagnosed with CTS were enrolled and treated with ultrasound-guided needle knife release of the transverse carpal ligament. Clinical and electrophysiological assessments were performed at baseline and 3 days post-treatment, including sensory nerve conduction velocity (SNCV), distal motor latency (DML), compound muscle action potential (CMAP) amplitude, ultrasound imaging parameters, and Numerical Rating Scale (NRS) scores for pain and numbness. Telephone follow-ups were conducted at 1 and 3 months to evaluate NRS, Boston Carpal Tunnel Questionnaire (BCTQ), and Short-Form 36 (SF-36) scores.
At 3 days post-treatment, significant improvements were observed in the median nerve flattening ratio and NRS scores for both pain and numbness (P<0.05). At 1 and 3 months, significant improvements were maintained in pain intensity, numbness intensity, symptom severity, and functional status as measured by BCTQ. The SF-36 domains of physical functioning (PF), bodily pain (BP), general health (GH), vitality (VT), role emotional (RE), and mental health (MH) all showed significant improvements at both time points, while social functioning (SF) showed significant improvement at 3 months (P<0.05). No adverse events were observed during the study period.
In this preliminary prospective case series, ultrasound-guided needle knife release of the transverse carpal ligament was associated with significant improvements in symptoms, hand function, and quality of life in patients with CTS, with a favorable safety profile. These findings support its potential as a minimally invasive treatment option for CTS.
Eighteen patients diagnosed with CTS were enrolled and treated with ultrasound-guided needle knife release of the transverse carpal ligament. Clinical and electrophysiological assessments were performed at baseline and 3 days post-treatment, including sensory nerve conduction velocity (SNCV), distal motor latency (DML), compound muscle action potential (CMAP) amplitude, ultrasound imaging parameters, and Numerical Rating Scale (NRS) scores for pain and numbness. Telephone follow-ups were conducted at 1 and 3 months to evaluate NRS, Boston Carpal Tunnel Questionnaire (BCTQ), and Short-Form 36 (SF-36) scores.
At 3 days post-treatment, significant improvements were observed in the median nerve flattening ratio and NRS scores for both pain and numbness (P<0.05). At 1 and 3 months, significant improvements were maintained in pain intensity, numbness intensity, symptom severity, and functional status as measured by BCTQ. The SF-36 domains of physical functioning (PF), bodily pain (BP), general health (GH), vitality (VT), role emotional (RE), and mental health (MH) all showed significant improvements at both time points, while social functioning (SF) showed significant improvement at 3 months (P<0.05). No adverse events were observed during the study period.
In this preliminary prospective case series, ultrasound-guided needle knife release of the transverse carpal ligament was associated with significant improvements in symptoms, hand function, and quality of life in patients with CTS, with a favorable safety profile. These findings support its potential as a minimally invasive treatment option for CTS.