Associations of Preoperative Ultrasonography, Nerve Conduction Studies, and CTS-6 to Boston Carpal Tunnel Questionnaires Up to One Year Following Carpal Tunnel Release

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-08-13 DOI:10.1016/j.jhsg.2025.100767

Jenna L. Dvorsky MS , Ryan T. Lin BS , Shaquille Charles MD, MSc , Madalyn Kostyal MD , Hannah Ong BS , John Fowler MD

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Abstract

Purpose

The purpose of this study was to evaluate the association between preoperative ultrasound, nerve conduction studies (NCS), and/or carpal tunnel syndrome-6 (CTS-6) scores and the postoperative courses of patients undergoing carpal tunnel release (CTR).

Methods

This was a retrospective study of all patients indicated for CTR at a single institution between October 2014 and August 2021. Preoperative data, including age, sex, body mass index, and laterality of the involved hand(s), were collected. Ultrasound was performed with a median nerve cross-sectional area (CSA) of ≥10 mm² considered positive for CTS. Nerve conduction studies evaluated the distal sensory and motor latencies of the median nerve. Carpal tunnel syndrome-6 scores ≥12 were considered positive for CTS. The primary outcome measurement was the Boston Carpal Tunnel Questionnaire (BCTQ). Statistical analysis was performed to assess the correlation of preoperative studies to predict changes in postoperative BCTQ scores following CTR. Statistical significance was set to P < .05.

Results

In total, 106 patients were included in the analysis, of which 69 patients were positive for CTS on US with an average median nerve CSA of 15.2 ± 4.4 mm², whereas 37 patients were negative with an average CSA of 9.0 ± 1.3 mm² (P < .001). Female sex, height, and weight were significantly different between the CTS-positive and -negative cohorts (P = .01, P = .02, and P = .01). Preoperative US, NCS, and CTS-6 were not associated with the ability to achieve minimal clinically important difference in change in BCTQ scores after surgery.

Conclusions

Although helpful in establishing a diagnosis of CTS, positive findings on preoperative US, NCS, and CTS-6 alone are not associated with clinically significant changes in BCTQ symptom or function scores up to 1 year after surgery following CTR.

Type of study/level of evidence

Prognostic IV.

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术前超声检查、神经传导研究和CTS-6与腕管松解后一年内波士顿腕管问卷的关系

目的本研究的目的是评估术前超声、神经传导研究（NCS）和/或腕管综合征-6 （CTS-6）评分与腕管释放（CTR）患者术后病程的关系。方法：这是一项回顾性研究，纳入了2014年10月至2021年8月在一家机构接受CTR治疗的所有患者。收集术前资料，包括年龄、性别、体重指数和受累手的侧边。超声检查时，正中神经横截面积(CSA)≥10 mm2为CTS阳性。神经传导研究评估了正中神经的远端感觉和运动潜伏期。腕管综合征-6评分≥12被认为是CTS阳性。主要结果测量是波士顿腕管问卷（BCTQ）。通过统计学分析评估术前研究与预测CTR术后BCTQ评分变化的相关性。统计学意义设为P <；. 05。结果共纳入106例患者，其中US上CTS阳性69例，平均正中神经CSA为15.2±4.4 mm2，阴性37例，平均CSA为9.0±1.3 mm2 (P <；措施)。女性性别、身高、体重在cts阳性组和阴性组之间存在显著差异（P = 0.01, P = 0.02, P = 0.01）。术前US、NCS和CTS-6与术后BCTQ评分变化达到最小临床重要差异的能力无关。结论术前US、NCS和CTS-6阳性结果与CTR术后1年内BCTQ症状或功能评分的临床显著变化无关，但有助于建立CTS的诊断。研究类型/证据水平

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