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Outcomes of a novel minimalist approach for the treatment of cubital tunnel syndrome
- Source :
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 22(6)
- Publication Year :
- 2014
-
Abstract
- 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.
- Subjects :
- Adult
Male
Reoperation
medicine.medical_specialty
Decompression
Cubital Tunnel Syndrome
Ulnar neuropathy
Cohort Studies
Patient satisfaction
Postoperative Complications
Physiology (medical)
medicine
Humans
Minimally Invasive Surgical Procedures
Ulnar nerve
Veterans Affairs
Ulnar Nerve
Cubital tunnel
Aged
Retrospective Studies
Aged, 80 and over
business.industry
General Medicine
Nerve injury
Middle Aged
medicine.disease
Decompression, Surgical
Surgery
medicine.anatomical_structure
Neurology
Patient Satisfaction
Cohort
Female
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 15322653
- Volume :
- 22
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
- Accession number :
- edsair.doi.dedup.....33c57007d95788e9cd3f936b610feace