The Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome
Study Details
Study Description
Brief Summary
Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy with involving compression of the median nerve in the carpal tunnel. Although many conservative managements of CTS, the effectiveness of these methods is insignificant or only persist for a short duration. The technique of nerve hydrodissection is now commonly used for peeling the nerve from surrounding soft tissue, which may help allow the impulse to pass, and rescue the nerve with ischemic damage. However, the exact effect and interval of hydrodissection are unknown because of the lack of well-designed studies Hence, investigators design a randomized, double- blind, controlled trail to assess the therapeutic effect of ultrasound-guided nerve hydrodissection in patients with CTS.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
After obtaining written informed consent, patients clinically diagnosed with mild-to-moderate CTS were inclused and randomized into three groups. Group A, patients received one-session of ultrasoung-guided nerve hydrodissection with 10cc normal saline; Group B, patients received one-session of ultrasoung-guided nerve hydrodissection with 5cc normal saline; The injection syringe was covered to obscure the nature of its contents and patients were asked to turn their head away so that they would not see the procedure. As a result, patients were blinded to the treatment condition. The primary outcome is Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and secondary outcomes include visual analog scale (VAS), cross-sectional area (CSA) of the median nerve, sensory nerve conduction velocity of the median nerve, and global assessment of treatment. The evaluations were performed pretreatment as well as on the 2nd week, 1st, 3rd and 6th month after injecton.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Group A Ultrasound-guided nerve hydrodissection with 10cc normal saline |
Procedure: Ultrasound-guided nerve hydrodissection
Ultrasound-guided nerve hydrodissection with 10cc normal saline between carpal tunnel and median nerve.
Device: Ultrasound
The ultrasound was used to measure cross-sectional area and injection guidance
Drug: Normal saline
The normal saline was used for injection solution
|
| Active Comparator: Group B Ultrasound-guided nerve hydrodissection with 5cc normal saline |
Procedure: Ultrasound-guided nerve hydrodissection
Ultrasound-guided nerve hydrodissection with 5cc normal saline between carpal tunnel and median nerve.
Device: Ultrasound
The ultrasound was used to measure cross-sectional area and injection guidance
Drug: Normal saline
The normal saline was used for injection solution
|
Outcome Measures
Primary Outcome Measures
- Change from baseline of severity of symptoms and functional status on 2nd week, 1st, 3rd and 6th month after injection [Pre-treatment, 2nd week, 1st, 3rd and 6th month after injection]
Using the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) to measure the severity of symptoms and functional status before treatment and multiple time frame after treatment. BCTQ includes two subscale (11 questions in symptom severity and 8 questions in functional status). The scores ranged from 0 to 5 points in each question, in which zero score refered to as mildest and no difficulty in activity; five scores mean most worst severity and dysfunction.
Secondary Outcome Measures
- Change from baseline of pain on 2nd week, 1st, 3rd and 6th month after injection [Pre-treatment, 2nd week, 1st, 3rd and 6th month after injection]
Using the Visual analog scale (VAS) to measure the pain scale before treatment and multiple time frame after treatment. The VAS score range from 10 (tremendously harsh pain) to 0 points (no pain)
- Change from baseline of cross-sectional area of the median nerve on 2nd week, 1st, 3rd and 6th month after injection [Pre-treatment, 2nd week, 1st, 3rd and 6th month after injection]
Using the musculoskeletal sonogram to measure the cross-sectional area of the median nerve before treatment and multiple time frame after treatment.
- Change from baseline of conduction velocity, amplitude of median nerve on 2nd week, 1st, 3rd and 6th month after injection [Pre-treatment, 2nd week, 1st, 3rd and 6th month after injection]
Antidromic sensory nerve conduction velocity of the median nerve before treatment and multiple time frame after treatment.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age between 20-80 year-old.
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Diagnosis was confirmed using an electrophysiological study
Exclusion Criteria:
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Cancer
-
Coagulopathy
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Pregnancy
-
Inflammation status
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Cervical radiculopathy
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Polyneuropathy, brachial plexopathy
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Thoracic outlet syndrome
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Previously undergone wrist surgery or steroid injection for CTS
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital | Taipei | Neihu District | Taiwan | 886 |
Sponsors and Collaborators
- Tri-Service General Hospital
Investigators
- Principal Investigator: Yung-Tsan Wu, MD, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- Nerve hydrodissection for CTS