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http://dx.doi.org/10.3340/jkns.2009.46.3.199

Pressure Measurement in Carpal Tunnel Syndrome : Correlation with Electrodiagnostic and Ultrasonographic Findings  

Ahn, Seong-Yeol (Department of Neurosurgery, Seoul National University College of Medicine)
Hong, Youn-Ho (Department of Neurology, Seoul National University Boramae Hospital)
Koh, Young-Hwan (Department of Radiology, Seoul National University Boramae Hospital)
Chung, Yeong-Seob (Department of Neurosurgery, Seoul National University Boramae Hospital)
Lee, Sang-Hyung (Department of Neurosurgery, Seoul National University Boramae Hospital)
Yang, Hee-Jin (Department of Neurosurgery, Seoul National University Boramae Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.46, no.3, 2009 , pp. 199-204 More about this Journal
Abstract
Objective : This study was done to evaluate the correlation between carpal tunnel pressure (CTP), electrodiagnostic and ultrasonographic findings in patients with carpal tunnel syndrome (CTS). Methods : CTP was measured during endoscopic carpal tunnel release (ECTR) for CTS using Spiegelberg ICP monitoring device with parenchymal type catheter. Neurophysiologic severity and nerve cross sectional area were evaluated using nerve conductive study and ultrasonography (USG) before ECTR in all patients. Results : Tests were performed in a total of 48 wrists in 39 patients (9 cases bilateral). Maximum CTP was $56.7{\pm}19.3$ mmHg ($Mean{\pm}SD$) and $7.4{\pm}3.3$ mmHg before and after ECTR, respectively. No correlation was found between maximum CTP and either neurophysiologic severity or nerve cross sectional area, whereas we found a significant correlation between the latter two parameters. Conclusion : CTP was not correlated with neurophysiologic severity and nerve cross sectional area. Dynamic, rather than static, pressure in carpal tunnel might account for the basic pathophysiology of CTS better.
Keywords
Carpal tunnel syndrome; Pressure; Ultrasonography; Electrodiagnosis;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
Times Cited By Web Of Science : 2  (Related Records In Web of Science)
Times Cited By SCOPUS : 3
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1 Brain WR, Wright AD, Wilkinson M : Spontaneous compression of both median nerves in the carpal tunnel : six cases treated surgically. Lancet 1 : 277, 1947   PUBMED
2 Gelberman RH, Hergenroeder PT, Hargens AR, Lundborg GN, Akeson WH : The carpal tunnel syndrome. A study of carpal canal pressures. J Bone Joint Surg Am 63 : 380-383, 1981   DOI   PUBMED
3 Hobson-Webb LD, Massey JM, Juel VC, Sanders DB : The ultrasonographic wrist-to-forearm median nerve area ratio in carpal tunnel syndrome. Clin Neurophysiol 119 : 1353-1357, 2008   DOI   ScienceOn
4 Nakamichi K, Tachibana S : Ultrasonographic measurement of median nerve cross-sectional area in idiopathic carpal tunnel syndrome : Diagnostic accuracy. Muscle Nerve 26 : 798-803, 2002   DOI   ScienceOn
5 Okutsu I, Ninomiya S, Yoshida A, Hamanaka I, Kitajima I : Measurement of carpal canal and median nerve pressure in patients with carpal tunnel syndrome. Tech Hand Up Extrem Surg 8 : 124-128, 2004   DOI   ScienceOn
6 Padua L, Pazzaglia C, Caliandro P, Granata G, Foschini M, Briani C, et al. : Carpal tunnel syndrome : ultrasound, neurophysiology, clinical and patient-oriented assessment. Clin Neurophysiol 119 : 2064-2069, 2008   DOI   ScienceOn
7 Park SK, Lee JH, Lee HG, Ryu KY, Kang DG, Kim SC : Predictive value of sensory nerve conduction in carpal tunnel syndrome. J Korean Neurosurg Soc 40 : 401-405, 2006   과학기술학회마을
8 Rempel D, Bach JM, Gordon L, So Y : Effects of forearm pronation supination on carpal tunnel pressure. J Hand Surg Am 23 : 38-42, 1998   DOI   ScienceOn
9 Nakao E, Short WH, Werner FW, Fortino MD, Palmer AK : Changes in carpal tunnel pressures following endoscopic carpal tunnel release : a cadaveric study. J Hand Surg Am 23 : 43-47, 1998   DOI   ScienceOn
10 Hashizume H, Nanba Y, Shigeyama Y, Hirooka T, Yokoi T, Inoue H : Endoscopic carpal tunnel pressure measurement : a reliable technique for complete release. Acta Med Okayama 51 : 105-110, 1997   PUBMED
11 Sekiya H, Sugimoto N, Kariya Y, Hoshino Y : Carpal tunnel pressure in patients with carpal tunnel syndrome due to long-term hemodialysis. Int Orthop 26 : 274-277, 2002   DOI   ScienceOn
12 Lee CH, Kim TK, Yoon ES, Dhong ES : Correlation of highresolution ultrasonographic findings with the clinical symptoms and electrodiagnostic data in carpal tunnel syndrome. Ann Plast Surg 54 : 20-23, 2005   DOI   ScienceOn
13 Kanta M, Ehler E, Hosszú T, Danková C, Lastovicka D, Adamkov J, et al. : [Measurement of carpal tunnel pressure during surgery of carpal tunnel syndrome.] Rozhl Chir 84 : 253-257, 2005   PUBMED
14 Werner R, Armstrong TJ, Bir C, Aylard MK : Intracarpal canal pressures : the role of finger, hand, wrist and forearm position. Clin Biomech (Bristol, Avon) 12 : 44-51, 1997   DOI   ScienceOn
15 Aroori S, Spence RA : Carpal Tunnel Syndrome. Ulster Med J 77 : 6-17, 2008   PUBMED
16 Okutsu I, Hamanaka I, Chiyokura Y, Miyauchi Y, Sugiyama K : Intraneural median nerve pressure in carpal tunnel syndrome. J Hand Surg Br 26 : 155-156, 2001   DOI   ScienceOn
17 Luchetti R, Schoenhuber R, Alfarano M, Deluca S, De Cicco G, Landi A : Carpal tunnel syndrome : correlations between pressure measurement and intraoperative electrophysiological nerve study. Muscle Nerve 13 : 1164-1168, 1990   DOI   ScienceOn
18 Ikeda K, Osamura N, Tomita K : Segmental carpal canal pressure in patients with carpal tunnel syndrome. J Hand Surg Am 31 : 925-929, 2006   DOI   ScienceOn
19 Schuind F : Canal pressures before, during, and after endoscopic release for idiopathic carpal tunnel syndrome. J Hand Surg Am 27 : 1019-1025, 2002   DOI   PUBMED   ScienceOn
20 Szabo RM, Gelberman RH, Williamson RV, Hargens AR : Effects of increased systemic blood pressure on the tissue fluid pressure threshold of peripheral nerve. J Orthop Res 1 : 172-178, 1983   DOI   PUBMED
21 Rojviroj S, Sirichativapee W, Kowsuwon W, Wongwiwattananon J, Tamnanthong N, Jeeravipoolvarn P : Pressures in the carpal tunnel. A comparison between patients with carpal tunnel syndrome and normal subjects. J Bone Joint Surg Br 72 : 516-518, 1990   PUBMED
22 Padua L, LoMonaco M, Gregori B, Valente EM, Padua R, Tonali P : Neurophysiological classification and sensitivity in 500 carpal tunnel syndrome hands. Acta Neurol Scand 96 : 211-217, 1997   PUBMED
23 Kaymak B, Ozçakar L, Cetin A, Candan Cetin M, Akinci A, Hascelik Z : A comparison of the benefits of sonography and electrophysiologic measurements as predictors of symptom severity and functional status in patients with carpal tunnel syndrome. Arch Phys Med Rehabil 89 : 743-748, 2008   DOI   ScienceOn
24 Koyuncuoglu HR, Kutluhan S, Yesildag A, Oyar O, Guler K, Ozden A : The value of ultrasonographic measurement in carpal tunnel syndrome in patients with negative electrodiagnostic tests. Eur J Radiol 56 : 365-369, 2005   DOI   ScienceOn
25 Luchetti R, Schoenhuber R, De Cicco G, Alfarano M, Deluca S, Landi A : Carpal-tunnel pressure. Acta Orthop Scand 60 : 397-399, 1989   DOI   PUBMED
26 Sanz J, Lizaur A, Sánchez Del Campo F : Postoperative changes of carpal canal pressure in carpal tunnel syndrome : a prospective study with follow-up of 1 year. J Hand Surg Br 30 : 611-614, 2005   DOI   ScienceOn
27 Bayrak IK, Bayrak AO, Tilki HE, Nural MS, Sunter T : Ultrasonography in carpal tunnel syndrome : comparison with electrophysiological stage and motor unit number estimate. Muscle Nerve 35 : 344-348, 2007   DOI   ScienceOn
28 Szabo RM, Chidgey LK : Stress carpal tunnel pressures in patients with carpal tunnel syndrome and normal patients. J Hand Surg Am 14 : 624-627, 1989   DOI   ScienceOn
29 Gelberman RH, Szabo RM, Williamson RV, Hargens AR, Yaru NC, Minteer-Convery MA : Tissue pressure threshold for peripheral nerve viability. Clin Orthop Relat Res : 285-291, 1983   PUBMED
30 Luchetti R, Schoenhuber R, Nathan P : Correlation of segmental carpal tunnel pressures with changes in hand and wrist positions in patients with carpal tunnel syndrome and controls. J Hand Surg Br 23 : 598-602, 1998   DOI   ScienceOn
31 Okutsu I, Ninomiya S, Hamanaka I, Kuroshima N, Inanami H : Measurement of pressure in the carpal canal before and after endoscopic management of carpal tunnel syndrome. J Bone Joint Surg Am 71 : 679-683, 1989   DOI   PUBMED
32 Werner CO, Elmqvist D, Ohlin P : Pressure and nerve lesion in the carpal tunnel. Acta Orthop Scand 54 : 312-316, 1983   DOI   PUBMED
33 Keir PJ, Bach JM, Rempel D : Effects of computer mouse design and task on carpal tunnel pressure. Ergonomics 42 : 1350-1360, 1999   DOI   ScienceOn