The authors retrospectively review 62 patients following carpal tunnel release surgery. The results of pre-operative electrophysiological studies were compared to pre-operative symptoms and outcome after surgery. No statistically significant relationship was found between the nature or duration of pre-operative symptoms and the severity of the electrophysiological impairment. Furthermore, no relationship was identified between pre-operative electrophysiological impairment and either post-operative symptomatic improvement or time to resolution of symptoms.
Grundberg (JHS, 1983) previously reported good success following median nerve decompression in patients with normal electrodiagnostic test results. Concannon et al (JPRS, 1997) studied patients with a clinical diagnosis of carpal tunnel syndrome, comparing those with positive and negative electrophysiological findings. They demonstrated no difference in outcome between the two groups following carpal tunnel release surgery. However, other authors have shown a correlation between poor surgical results and extreme neurophysiological impairment (Padua et al, JHS, 1999). Although there is no uniform consensus regarding the role of electrophysiological testing in the management of carpal tunnel syndrome, an appropriately performed test can be helpful in some situations, such as excluding other causes of nerve symptomatology in unclear cases. This report, however, further documents that patient selection for surgery must involve more that just electrodiagnostic testing. Furthermore, the results of this test appear to have limited utility with respect to prognosis following surgical release.
Journal of Hand Surgery