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This study addresses the pressing clinical question of optimizing surgical and pharmacological interventions for severe Carpal Tunnel Syndrome (CTS), a prevalent and debilitating condition caused by median nerve compression. Previous research has established the efficacy of Open Carpal Tunnel Release (OCTR) and Endoscopic Carpal Tunnel Release (ECTR); however, the role of neurotrophic supplementation in enhancing surgical outcomes has yet to be fully elucidated. Using a prospective clinical approach involving 497 patients, we evaluated the comparative outcomes of ECTR and OCTR with or without neurotrophic supplementation. Key findings demonstrate that ECTR, particularly when combined with neurotrophic agents, facilitates faster recovery and greater improvements in Sensory Nerve Conduction Velocity (VCS) and Visual Analog Scale (VAS) scores, with reduced complication rates compared to OCTR
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open Carpal Tunnel Release without Neurotrophic |
| ||
| Endoscopic Carpal Tunnel Release without Neurotrophic |
| ||
| Open Carpal Tunnel Release with Neurotrophic |
| ||
| Endoscopic Carpal Tunnel Release with Neurotrophic |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endoscopic Carpal Tunnel Release | Procedure | Release of carpal tunnel with endoscopic device |
|
| Measure | Description | Time Frame |
|---|---|---|
| SCV evaluation | SCV will be evaluated through electomyography after ECTR or OCTR with or without neurotrophic supplementation | 12 months of follow-up |
| VAS for pain evaluation | VAS for pain will be evaluated through questionnarie after ECTR or OCTR with or without neurotrophic supplementation | 12 months of follow-up |
| VAS for funcionality evaluation | VAS for functionality will be evaluated through questionnarie after ECTR or OCTR with or without neurotrophic supplementation | 12 months of follow-up |
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Inclusion Criteria:
Exclusion Criteria:
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patients diagnosed with severe Carpal Tunnel Syndrome from Policlinico of Bari
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Policlinico di Bari | Bari | Italy | Italy |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28205185 | Background | Desideri I, Francolini G, Becherini C, Terziani F, Delli Paoli C, Olmetto E, Loi M, Perna M, Meattini I, Scotti V, Greto D, Bonomo P, Sulprizio S, Livi L. Use of an alpha lipoic, methylsulfonylmethane and bromelain dietary supplement (Opera(R)) for chemotherapy-induced peripheral neuropathy management, a prospective study. Med Oncol. 2017 Mar;34(3):46. doi: 10.1007/s12032-017-0907-4. Epub 2017 Feb 15. | |
| 38011355 |
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| Open carpal tunnel release | Procedure | Release of carpal tunnel with open tecnique |
|
| Neurotrophic supplementation | Drug | Neurotrophic supplementation after surgery |
|
| Background |
| Nikbakht S, Vafaei MA, Ashraf A, Nasiri A, Nikpay-Hosseinabad N. Assessment of L-carnitine effectiveness on carpal tunnel syndrome. Curr J Neurol. 2022 Jul 6;21(3):162-169. doi: 10.18502/cjn.v21i3.11109. |
| 31405030 | Background | Salehi B, Berkay Yilmaz Y, Antika G, Boyunegmez Tumer T, Fawzi Mahomoodally M, Lobine D, Akram M, Riaz M, Capanoglu E, Sharopov F, Martins N, Cho WC, Sharifi-Rad J. Insights on the Use of alpha-Lipoic Acid for Therapeutic Purposes. Biomolecules. 2019 Aug 9;9(8):356. doi: 10.3390/biom9080356. |
| 25177448 | Background | Kim PT, Lee HJ, Kim TG, Jeon IH. Current approaches for carpal tunnel syndrome. Clin Orthop Surg. 2014 Sep;6(3):253-7. doi: 10.4055/cios.2014.6.3.253. Epub 2014 Aug 5. |
| 34150584 | Background | Orhurhu V, Orman S, Peck J, Urits I, Orhurhu MS, Jones MR, Manchikanti L, Kaye AD, Odonkor C, Hirji S, Cornett EM, Imani F, Varrassi G, Viswanath O. Carpal Tunnel Release Surgery- A Systematic Review of Open and Endoscopic Approaches. Anesth Pain Med. 2020 Dec 26;10(6):e112291. doi: 10.5812/aapm.112291. eCollection 2020 Dec. |
| 23809470 | Background | Zieske L, Ebersole GC, Davidge K, Fox I, Mackinnon SE. Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes. J Hand Surg Am. 2013 Aug;38(8):1530-9. doi: 10.1016/j.jhsa.2013.04.024. Epub 2013 Jun 25. |
| 25135849 | Background | Sayegh ET, Strauch RJ. Open versus endoscopic carpal tunnel release: a meta-analysis of randomized controlled trials. Clin Orthop Relat Res. 2015 Mar;473(3):1120-32. doi: 10.1007/s11999-014-3835-z. Epub 2014 Aug 19. |
| 23806914 | Background | Soltani AM, Allan BJ, Best MJ, Mir HS, Panthaki ZJ. A systematic review of the literature on the outcomes of treatment for recurrent and persistent carpal tunnel syndrome. Plast Reconstr Surg. 2013 Jul;132(1):114-121. doi: 10.1097/PRS.0b013e318290faba. |
| 25191172 | Background | Means KR Jr, Dubin NH, Patel KM, Pletka JD. Long-term outcomes following single-portal endoscopic carpal tunnel release. Hand (N Y). 2014 Sep;9(3):384-8. doi: 10.1007/s11552-014-9614-1. |
| 26441187 | Background | Atroshi I, Hofer M, Larsson GU, Ranstam J. Extended Follow-up of a Randomized Clinical Trial of Open vs Endoscopic Release Surgery for Carpal Tunnel Syndrome. JAMA. 2015 Oct 6;314(13):1399-401. doi: 10.1001/jama.2015.12208. No abstract available. |
| 32723265 | Background | Marvulli R, Ianieri G, De Venuto G, Falcicchio M, Gallo GA, Mennuni C, Gallone MF, Fiore P, Ranieri M, Megna M. Electrophysiological and Clinical Improvement in Non-Invasive Treatment of Carpal Tunnel Syndrome. Endocr Metab Immune Disord Drug Targets. 2021;21(2):345-351. doi: 10.2174/1871530320666200728152953. |
| 10487914 | Background | Stevens JC, Smith BE, Weaver AL, Bosch EP, Deen HG Jr, Wilkens JA. Symptoms of 100 patients with electromyographically verified carpal tunnel syndrome. Muscle Nerve. 1999 Oct;22(10):1448-56. doi: 10.1002/(sici)1097-4598(199910)22:103.0.co;2-y. |
| 9583428 | Background | Nordstrom DL, DeStefano F, Vierkant RA, Layde PM. Incidence of diagnosed carpal tunnel syndrome in a general population. Epidemiology. 1998 May;9(3):342-5. |
| 11805259 | Background | Mondelli M, Giannini F, Giacchi M. Carpal tunnel syndrome incidence in a general population. Neurology. 2002 Jan 22;58(2):289-94. doi: 10.1212/wnl.58.2.289. |
| 23076750 | Background | Spahn G, Wollny J, Hartmann B, Schiele R, Hofmann GO. [Metaanalysis for the evaluation of risk factors for carpal tunnel syndrome (CTS) Part II. Occupational risk factors]. Z Orthop Unfall. 2012 Oct;150(5):516-24. doi: 10.1055/s-0032-1315346. Epub 2012 Oct 17. German. |
| ID | Term |
|---|---|
| D002349 | Carpal Tunnel Syndrome |
| ID | Term |
|---|---|
| D020423 | Median Neuropathy |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D009408 | Nerve Compression Syndromes |
| D012090 | Cumulative Trauma Disorders |
| D013180 | Sprains and Strains |
| D014947 | Wounds and Injuries |
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